- Fill out and save the CUIDAR Enrollment Form
- E-mail email@example.com or fax the CUIDAR Enrollment form
Submit payment through our secure online form
You will be contacted within 24 hours by a coordinator to confirm your enrollment.
- E-mail: the CUIDAR Enrollment Form as an attachment
- Fax: 949-824-3198
- Call an Enrollment Coordinator to complete the Enrollment Form and collect payment over the phone.
- For parents of children 0 through 5 years of age
call (949) UCI-CHOC (824-2462)