West Virginia Bureau for Children and Families
NOTE: You are using an outdated browser. In order to view, use, and enjoy this site to the fullest, we strongly recommend upgrading your browser to one that supports web standards.

Dynamic Menu Mouse


Default Text Default Text | Large Text | Larger Text Large Text
Page Modified: Friday, April 11, 2014

Become a Special Needs Provider

This form is for West Virginia residents only.

Thank you for taking a few moments to fill out the special needs inquiry form. The information you submit will be given to the state Program Manager. For details regarding your privacy please review the WVDHHR Privacy Policy.

Have you ever been a Specialized Family Care or Foster Care Provider?  
Do you want to provide care for adults?  
Do you want to provide care for children?  
If yes, what age of child would you be interested in providing care for?
What is your current age?
What is your gender?
What is your current marital status?
Would you consider providing care for a child or adult that,
  • needing help bathing, dressing, feeding
  • need help with physical assistance to move about
  • transferring from bed to chair and back
  • have a wheelchair or other device for mobility
Do you have any special training, i.e. medical, psychological?
Would you be willing to particpate in training to learn new parenting skills and knowledge?
Are you interested in learning more about becoming a specialized family care provider?
Would you like to have a Family Based Care Specialist call you?
 Not from West Virginia?

Please review your information for accuracy before submitting.

Print Content Print Content Email Page Email Page Bookmark this Page Bookmark Page