Get Youth In Care Intake Form

Completing the Youth in Care Intake Form online is an essential process for ensuring the proper care and support of the youth involved. This guide provides clear instructions for each section of the form to help users navigate it effectively.

Follow the steps to complete the form efficiently.

1. Press the ‘Get Form’ button to access the Youth in Care Intake Form and open it in your preferred document editor.
2. Begin by filling out the 'Student Name' and 'Caseworker/Manager Name' fields accurately. Make sure to include the full names as they appear in official documents.
3. In the certification section, confirm the legal custody status by selecting the appropriate agency (e.g., DCFS, DJJS) and providing the signature of the caseworker/manager.
4. Enter the contact details for the caseworker, including email, agency, address, and phone numbers in the respective fields.
5. Proceed to the 'STUDENT INFORMATION' section. Fill in the preferred name, birth date, age, current grade, sex, ethnicity, and phone number.
6. Identify primary contact people by writing their names, relationship to the student, and phone numbers in the designated fields.
7. Indicate parental contact status by selecting yes, no, or restricted, and provide relevant court information including the judge's name, court case number, and pending court date.
8. In the 'PLACEMENT INFORMATION' section, fill out the provider agency name, placement parent's or group home's name and phone number, address, and email address.
9. For the 'EDUCATIONAL INFORMATION' part, list previous schools attended, district name, and indicate any special education services or violations.
10. Complete the social/medical information section by providing current medications, allergies, and information on counseling services if applicable.
11. Finally, at the end of the form, ensure all fields are completed accurately. You can then save changes, download a copy of the form, print it, or share it as required.

Complete your Youth in Care Intake Form online today for timely support.