Starting services for Juvenile Justice and Child Welfare children
1. The Universal Child Welfare Packet includes:
- Service Entry Authorization
- Foster Care or Juvenile Justice Mental Health Referral
- Authorization to Release Confidential Information – We will need multiple forms to exchange information with at least the following:
- Foster Care Contractor or Juvenile Justice
- Foster Parent, if applicable (your discretion)
- Primary Care Physician
- Previous Mental Health Providers
- Consent for Mental Health Treatment
- Custody Status/Educational Placement/Residential Setting
- Juvenile Justice & Law Enforcement/Recent History of Present Situation
- Family History of Mental Illness
- Family Information
- Medical Information
- Consent to Photograph
2. Click the “Child Welfare Document Packet” button below, print out all the forms and sign in the designated areas.
3. Fax all paperwork to FSGC (785.234.4853) – Attention: Admissions
If you experience difficulties opening any forms, please contact our Admissions office at 785.232.5005. We will be happy to email or fax a copy of the forms.
We look forward to serving your needs. If you have any questions, contact Family Service & Guidance Center at 785.232.5005 and ask for Admissions.
Have any questions about forms?
Reach out to FSGC for additional information about Juvenile Justice and Child Welfare forms.