Child Care Resource and Referral
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Child Care Resource and Referral

Contact Information
Child Care Resource and Referral would appreciate a response from you to let us know how successful your child care search has been. Please wait to complete this follow-up form until after you have attempted to locate child care. Thank you for your time in completing this form. Your comments and information are helpful!
Quality of CCR&R services:


Phone Number:

Full Name:





Month of original
referral call:

Decision made:
Type of care selected:

How did you find your child care?
If other, please explain:

What factors did you consider when making your decision? (choose up to three)

Were there any problems encountered? (choose up to three)

If other, please explain:

The referral list I received was accurate (for example, contact information, schedule).

The referral specialist I spoke with was polite and courteous.

The overall quality of service was helpful.

Did the referral list help you learn more about your child care options?  
Did the written materials about child care help you learn more about how to select a child care program?  
If no, why?

What is your previous experience with child care?

If needed would you use this referral service again?  
If no, why?

What suggestions do you have for improving our service?

Lend a Helping Hand
CCR&R of Northeast Iowa
Exceptional Persons, Inc.

P.O. Box 4090
3675 University Avenue
Waterloo, IA 50704-4090

Ph: (800) 475-0804