Family Services

Home Instruction for Parents of Preschool Youngsters

Home Instruction for Parents of Preschool Youngsters (HIPPY) is a structured, home-based model focused on parent-child centered learning designed to remove barriers and to reach low income families with limited education to become their child’s first teacher. The family is provided with a set of developmentally appropriate materials, curriculum, and books designed to strengthen their children’s cognitive skills, early literacy skills, social/emotional and physical development.

Through HIPPY, parents not only become actively involved in the lives of their children, but they also assist their children to reach their full potential as they prepare to enter school. The HIPPY program is available for children ages 2 – 5 years old.

HIPPY is available to families in Broward, Palm Beach and Miami Dade.

Contact Information:

Broward

Clara Perea
(954) 724-4075

cl********@fa***********.org

Broward Intake Form

HIPPY Broward Intake Form

Please fill out the form below, and someone from our office will be in touch once your application has been reviewed. If you prefer to download a paper copy and send it back via fax, you can do so by clicking here.

Applicant Information (Parent Information)

Last Name*

First Name*

Your Email*

Address*

City*

Zip*

Type of Residence*

HouseApartmentTownhome

Number/Unit/Building*

At least one phone number is required in order for your application to be considered.

Home Phone

Work Phone

Other Phone

Languages Spoken*

EnglishSpanishCreoleOther

Other

If you selected "Other" please list them here.

Preferred Language*

Best time to contact*

MorningAfternoonEveningAny

Child(ren) Information

Child 1

Last Name*

First Name*

Date of Birth*

mm/dd/yyyy

Age*

HIPPY Age*

Child 2

Last Name

First Name

Date of Birth

mm/dd/yyyy

Age

HIPPY Age

Additional Children Information

If you are interested in enrolling more than 2 children, please provide first and last names, date of birth, age and HIPPY age in this area.

How did you hear about the HIPPY Program?*

Referral Made By*

SelfSchool/PreschoolFamily MemberReturning ClientOther

Other

If you selected "other" please explain here.

Family Information

Family Size*

Either Annual Income OR Monthly Income must be provided.

Annual Income

Monthly Income

44248

Miami Dade

Diana Palacios
(305) 749-8616

di***********@fa***********.org

Miami Intake Form

HIPPY Miami Dade Intake Form

Applicant Information (Parent Information)

Last Name*

First Name*

Parent Date of Birth*

mm/dd/yyyy

Your Email*

Address*

City*

Zip*

Number/Unit/Building*

At least one phone number is required in order for your application to be considered.

Home Phone

Work Phone

Other Phone

Race*

Black/African AmericanWhite

Ethnicity*

Non-HispanicHaitianHispanic

Languages Spoken*

EnglishSpanishCreoleOther

Other

If you selected "Other" please list them here.

Preferred Language*

Relationship to Child (REN)*

MotherFatherGuardian

Marital Status*

MarriedSingleDivorcedSeparatedOther
Other

If you selected "Other" please explain.

Highest Education Level*

High SchoolAssociateBachelorsMastersOther
Other

If you selected "Other" please describe.

Best time to contact*

MorningAfternoonEveningAny

Child(ren) Information

Child 1

Last Name*

First Name*

Date of Birth*

mm/dd/yyyy

Gender*

MaleFemale

Documented Disability*

Learning, Emotional, Profound, Physical, Sensory

Does the child have health insurance?*

YesNo

Enrolled in subsidized Pre-K / Childcare?*

YesNo

Child 2

Last Name

First Name

Date of Birth

mm/dd/yyyy

Gender

MaleFemale

Documented Disability

Learning, Emotional, Profound, Physical, Sensory

Does the child have health insurance?

YesNo

Enrolled in subsidized Pre-K /Childcare?

YesNo

Additional Children Information

If you are interested in enrolling more than 2 children, please provide the same information for any additional children.

Family Information

Number of Adults*

Number of Children*

Either Annual Income OR Monthly Income must be provided.

Annual Income

Monthly Income

68123

Palm Beach

Martha Gomez

ma*********@fa***********.org

Palm Beach Intake Form

HIPPY Miami Dade Intake Form

Applicant Information (Parent Information)

Last Name*

First Name*

Your Email*

Address*

City*

Zip*

Type of Residence*

HouseApartmentTownhome

Number/Unit/Building*

At least one phone number is required in order for your application to be considered.

Home Phone

Work Phone

Other Phone

Languages Spoken*

EnglishSpanishCreoleOther

Other

If you selected "Other" please list them here.

Preferred Language*

Best time to contact*

MorningAfternoonEveningAny

Child(ren) Information

Child 1

Last Name*

First Name*

Date of Birth*

mm/dd/yyyy

Age*

HIPPY Age*

Child 2

Last Name

First Name

Date of Birth

mm/dd/yyyy

Age

HIPPY Age

Additional Children Information

If you are interested in enrolling more than 2 children, please provide first and last names, date of birth, age and HIPPY age in this area.

How did you hear about the HIPPY Program?*

Referral Made By*

SelfSchool/PreschoolFamily MemberReturning ClientOther

Other

If you selected "other" please explain here.

Family Information

Family Size*

Either Annual Income OR Monthly Income must be provided.

Annual Income

Monthly Income

33985

Nurturing Parenting Program

The Nurturing Parenting Program is a short term intensive in-home visitation parent education program using the Nurturing Parenting Skills for Families framework. Families and their children, birth – 11 years old, are eligible for services. All sessions are designed to promote the 5 Nurturing Constructs and 5 Protective factors that form the core service delivery and provide an opportunity for strength based wraparound case management services. Total service time is approximately 18-20 weeks.

Nurturing Parenting Program is available to families in Broward and Miami Dade.

Contact Information:

Broward

Monica Peña
(954) 724-3907

Broward Intake Form

Parenting Education Program Inquiry for Services (Broward)

Applicant Information (Parent Information)

Last Name*

First Name*

Parent Date of Birth*

mm/dd/yyyy

Your Email*

Address*

City*

Zip*

Number/Unit/Building*

Broward Resident*

YesNo

Best time to contact*

MorningAfternoonEveningAny

Days of the week*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Home Phone

Languages Spoken*

EnglishSpanishCreoleOther

Other

If you selected "Other" please list them here.

Preferred Language*

Race*

Black/African AmericanWhite

Gender*

MaleFemale

Food allergies or any known health concerns?

Family Information

Family Size*

Child(ren) Information

Child 1

Please include all children in the household birth to 11 years old.

Last Name*

First Name*

Date of Birth*

mm/dd/yyyy

Current Age*

Current Grade in School

Child 2

Last Name

First Name

Date of Birth

mm/dd/yyyy

Current Age

Current Grade in School

Child 3

Last Name

First Name

Date of Birth

mm/dd/yyyy

Current Age

Current Grade in School

Additional Children Information

If you are interested in enrolling more than 3 children, please provide first and last names, date of birth, current age and current grade in school in this area.

What concerns would you like help with?*

Child DevelopmentLife Event (Marriage, Divorce, Birth of Baby)Improve Family InteractionsSchool-Related Issues/ConcernsFamily StressorsEffective Discipline TechniquesOther

Other

If you answered "other" please explain.

27039

Miami Dade

Claudia Lear
(305) 749-8603

Miami Intake Form

Nurturing Miami Dade Intake Form

Applicant Information (Adult Information)

Are you a parent, guardian, or primary caregiver?*

YesNo

How many children are in your care?

How many of the children in your care have a disability or condition that is expected to last for a year or more that makes it harder for your child to do things that other children the same age can do?

Number of children*

Last Name*

First Name*

Middle Initial*

Your Email*

Date of Birth*

mm/dd/yyyy

Primary Phone*

The best number for us to contact you.

Address*

City*

Zip*

Number/Unit/Building*

Gender*

MaleFemale

Proficient in English

YesNo

Languages Spoken*

EnglishSpanishCreoleOther

Other

If you selected "Other" please list them here.

Preferred Language*

Please tell us the language in which you'd like to receive communication.

Ethnicity*

Non-HispanicHaitianHispanic

Race*

Black/African AmericanWhite

Highest Education Level Completed*

High SchoolAssociateBachelorsMastersOther

Other

If you answered "other" please explain.

Child(ren) Information

Child 1

Last Name*

First Name*

Date of Birth*

mm/dd/yyyy

Gender*

MaleFemale

Social Security Information
Last 4 digits ONLY

Mark as NA for no SSN, or Not Given if you prefer not to give your SSN.

Miami-Dade Public School Information
School ID#

Mark as NA for no no MDCPS ID, or Not Given if you prefer not to give your MDCPS ID.

Current School Information

Current Grade in School

Proficient in English

YesNo

Other languages spoken in the home

Child's Ethnicity*

Child's Race*

Does child have health insurance

YesNo

Does your child have any Special Needs or health concerns?

YesNo

Child 2

Last Name*

First Name*

Date of Birth*

mm/dd/yyyy

Gender*

MaleFemale

Social Security Information
Last 4 digits ONLY

Mark as NA for no SSN, or Not Given if you prefer not to give your SSN.

Miami-Dade Public School Information
School ID#

Mark as NA for no no MDCPS ID, or Not Given if you prefer not to give your MDCPS ID.

Current School Information

Current Grade in School

Proficient in English

YesNo

Other languages spoken in the home

Child's Ethnicity*

Child's Race*

Does child have health insurance

YesNo

Does your child have any Special Needs or health concerns?

YesNo

Additional Children Information

If you are interested in enrolling more than 3 children, please provide first and last names, date of birth, current age and current grade in school in this area.

Comments

39076

Family Services

This intensive, short term family stabilization program serves families at high risk for abuse and/or neglect. Mental health professionals provide home and community based services and assist with needed referrals to ensure child safety and family stabilization.

Referrals are currently only accepted from Cirtus Family Care Network at this time.

Contact Information:

Wendy Salomon
(305) 749-8611

WS******@fa***********.org

Benefit Enrollment Services

This service helps families navigate the complicated benefits system by supporting application completion and submission along with referrals to community organizations. This program is available to low-income families with children ages birth to 17 years old in Miami Dade County.

Contact Information:

Diana Palacios
(305) 749-8616

di***********@fa***********.org

Needs Assessment

Benefits Enrollment Needs Assessment

Please fill out the form below, and someone from our office will be in touch once your application has been reviewed.

Applicant Information

First Name*

Last Name*

Email*

Phone Number*

What County Do You Live In?*
BrowardMiami-Dade

What social Services do you and/or your child(ren) need at this time?*

Adult Education & EmploymentBehavioral TherapyChild Care & Development FundClothing AssistanceConcerns with HearingConcerns with VisionDisabilityDiscount Phone, Wireless, & Broadband ServicesEarly Head StartEITC/CTC (Earned Income Tax Credit/Child Tax Credit)Emergency Food AssistanceEmployment TrainingEnglish as a Second LanguageFamily CounselingFinancial Literacy Education & SupportGED PreparationHead StartHealth Insurance & Health CareHousing Assistance ProgramsImmigration ServicesImmunizationsIndividual CounselingLIHEAP (Low Income Home Energy Assistance ProgramLow/No Cost After School and Summer ProgramsNational School Lunch ProgramOccupational TherapyParenting ClassesPhysical TherapySNAP (Supplemental Nutrition Assistance ProgramSpeech/Language TherapySSI/DisabilitySubstance Use TreatmentTANF (Temporary Assistance for Needy FamiliesTCA (Temporary Cash AssistanceTransportationWIC

92524