Family Finding - Caseworker Referral Q & A


County:
Referral Date:
 Case Name:
Case Number:
 Child/Children's Names:
Case Worker:
 Case Worker Supervisor:
Case Worker Phone:
 Case Worker E-Mail:

Question 1 - What would be your goal for this case now that it has been referred to Family Finding?

Question 2 - What is the current permanency plan for the child?

Question 3 - Legal Father (is there one recognized?)

Question 4 - Mother's Last Contact?

Question 5 - Relatives or connections that are currently involved?

Question 6 - Stability of current placement?

Question 7 - Is there a permanent resource for the youth? If yes, who?

Yes  No Who?

Question 8 - Safety concerns around this case?

Question 9 - Others working on case with youth

CASA Mentor Other
Name:
 Name:
 Name:
Phone:
 Phone:
 Phone:
E-Mail:
 E-Mail:
 E-Mail: