For Caseworker-

Life Story Book
Volunteer Request Form




The form below will notify our lifebook team to swing into action. It is all that is needed. But if you would like to assist the effort with specialized knowledge that you have about the child or children, you assistance is welcome! It will help our lifebook team if you can fill out this longer form and mail or fax it back to us at (541)-343-2866.

Date of Request
Caseworker Name
Caseworker Phone
Case name (DHS #)
Childs name Date of Birth
Male
Female

Date book needs to be completed:

Special instructions/requests for completed book: