Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the GROUP HOME REFERRAL form and open it in your preferred editor.
2. Begin by entering the child's name and date of birth in the respective fields at the top of the form. Ensure accuracy in these details as they are crucial for identification.
3. Provide the care coordinator's name and contact number. This information is essential for communication regarding the child's placement.
4. Specify the target date for placement and the anticipated length of placement. These fields help in planning and managing the transition.
5. Detail the initial out-of-home placement date and current placement, including the date they were placed. This information provides context about the child's history.
6. Articulate the statement of need and expected outcomes from the placement thoroughly. This should reflect the reasons for referral and what is hoped to be achieved through the placement.
7. Identify the primary referral issue (e.g., AODA, sex offense) and any charges if the child is delinquent. This information is crucial for the reviewing authorities.
8. Indicate whether a special staffing pattern is required and provide an explanation if necessary. This is important for ensuring the child's needs are met.
9. Specify if a roommate is acceptable for the child by checking either 'Yes' or 'No.' Include any relevant peer age issues.
10. Address community and safety concerns in the designated section. This is essential for the safety and well-being of the child.
11. Fill out the 'Physical/Medical Information' section, including gender, ethnicity, height, weight, physician details, and current medications.
12. In the visitation section, indicate whether visitation will be supervised and list any specific requirements or restrictions.
13. Complete the 'Critical Transitional Information' section, providing insights on facilitating a smooth transition and preferred interventions.
14. If applicable, provide supplemental information regarding the permanency plan, court information, and medical details.
15. Describe the child's strengths and talents, family history, and current family involvement, ensuring to detail contact dynamics.
16. Finally, detail any cultural or spiritual preferences, history of abuse or neglect, behavioral challenges, and academic functioning.
17. Once all sections are completed, review for accuracy and completeness. Save changes, then download, print, or share the completed form as necessary.

Begin filling out the GROUP HOME REFERRAL online today to ensure a smooth process for the child and their family.