Try for free

Yukon Child Care Subsidy Special Needs Application

Yukon families applying for the Early Learning and Child Care Subsidy use this one-page form when a professional assessment shows a special need of the child or family. The professional selects one or more of five grounds, explains the need and recommends hours of care. The Early Learning and Child Care Branch uses it to assess the need for subsidized care.

Who completes it

A physician, psychiatrist, social worker, child development specialist or other qualified professional who can speak to the child's needs completes the professional section and signs the declaration. The form names the parent applicant and the children, and the parent files it with the subsidy application.

Submitting and payment

How to submit it
The parent submits it with the child care subsidy application in person at the Early Learning and Child Care Branch in Whitehorse or by mail. Original signatures are required, so scanned or emailed copies are not accepted.

Good to know

  • Each ground carries a care maximum: 6 months for child protection, assessed special needs or developmental enrichment, 3 months for respite and 1 month for a short-term family crisis.
  • Choosing the developmental enrichment ground requires an Individual Program Plan, most often prepared by a professional at the Child Development Centre.
  • If the professional cannot complete the form, the same information can be provided instead in a letter from that professional.
  • Children with special needs remain eligible up to age 16, compared with 12 and under for other children, and subsidy maximums depend on age, hours and special needs.

Get the official form

Download the current version from the source each time; forms change without notice.

Child care subsidy special needs application form

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

See how Vero Documents works

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Who can sign the Yukon child care special needs form?

A qualified professional who can speak to the child's needs and has the training and skills to make the recommendation, such as a physician, psychiatrist, social worker or child development specialist. Nurses and support workers are also named as typical recommenders for some grounds.

What does the professional recommend on the form?

After checking at least one ground and explaining it, the professional recommends early learning and child care for a number of hours per day and days per week, and a total length of time within the maximum for that ground, then signs and dates a declaration.

Can the form be emailed to the Early Learning and Child Care Branch?

No. Yukon requires original signatures on child care subsidy applications, so scanned or emailed applications are not accepted. The form and the application go to the branch in person in Whitehorse or by mail.