Cps referral form 2025

1. Click ‘Get Form’ to open the cps referral form in the editor.
2. Begin by filling in the 'CPS/FC Social Worker' and 'Date' fields at the top of the form. This identifies who is submitting the referral.
3. In the 'Placement Referral' section, select the appropriate option (e.g., Change, New Placement) that applies to your situation.
4. Complete the 'Case Name' and 'Case Number' fields, followed by entering details for both parents/responsible adults, including their names and dates of birth.
5. Indicate the relationship of the first parent/responsible adult to the child by selecting from options such as Parent or Licensed Foster Parent.
6. Fill in child-specific information including name, date of birth, and SS# if applicable. Select gender and race options as required.
7. In the 'Reason Child Care Services Are Needed For Child' section, check all relevant boxes and provide additional explanations where necessary.
8. Specify child care specifics such as provider requested, days and times care is needed, and any transportation requests.
9. Finally, ensure that all changes are reported promptly as indicated in the responsibility section before signing off with worker signatures.

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