Family Finding - Caseworker Referral Q & A

County:
Referral Date:
Case Number:
Case Name:
Child/Children's Names:
Child/Children's
Birth-Month-and-Year or Ages

Case Worker Name:
Case Worker E-Mail:
Case Worker Phone:
Case Worker Supervisor
[optional]:

What is the current permanency plan for the child?

Is there a permanent resource for the youth? If yes, who?


Who?

Ethnic Background of the Child or Children

[ALL OF THE FOLLOWING ARE VERY HELPFUL, BUT OPTIONAL]

Do You need Family Finding Reports For A Future Court Date?
If so, when is it?


When?

What would be your goal for this case now that it has been referred to Family Finding?

Legal Father (is there one recognized?)

Mother's Last Contact?

Relatives or connections that are currently involved?

Stability of current placement?

Safety concerns around this case?

Length of Time in Care

Number of Times the Child Has Moved, While in Care (if Known)

Others working on this case with the youth?

CASA
Name:

Phone:

Email:



 
Mentor
Name:

Phone:

Email:


 
Attorney
Name:

Phone:

Email:


 
Foster Parent
Name:

Phone:

Email:


 
Other
Name:

Phone:

Email:


 

Other Relatives Known to the Agency

Relationship:

Name:

Phone:

Email:


 
Relationship:

Name:

Phone:

Email:


 
Relationship:

Name:

Phone:

Email:


 
Relationship:

Name:

Phone:

Email:


 
Relationship:

Name:

Phone:

Email:


 


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