Foster Care Placement Call Questionnaire Template printable pdf download

General Information

Name

Age

Birthday

Child's Assigned Worker

Does the child have any siblings?

If so, where are they now?

Are you looking for a placement to take siblings together?

Medical Information:

Diagnosed or suspected medical needs

Allergies

Special services/appointments required

What languages does the child speak? More than one?

What is the race/ethnicity and religion of the child?

Are there cultural requirements/requests to be considered for this child

Child's Background

Why is the child in foster care?

How long has the child been in foster care?

How many moves has the child had?

Are there special routines the child is used to? Schedules to keep in mind?

Visitation

How often does the child have visitation with their birth family?

Who gets visitation (Mom, Dad, other relatives?)

Where are the visits held?

If the child has siblings not in my home, do they have visitation with them?

School

Is the child in school or do they need to be registered?

What school do they currently attend?

Are they able to transfer to the local school?

How are they doing in school?

Is the child receiving any special services from the school?

Time Frame / Permanency

Is there an estimated Foster Care time frame?

Has kinship been considered or ruled out?

Has the child’s parent been working on their case plan?

Foster Care Placement Call Questionnaire Template