Child Welfare Forms

CHILD AND ADOLESCENT NEEDS AND STRENGTHS (CANS)

• CANS Overview

CHILD LOCATOR FORMS

• Missing and Endangered Criteria
• Missing From Care Reporting Form
• Return to Care Form

HEARING REQUEST FORM

• CPS/APS Hearing Request Form (2024)

FOSTER CARE

• Client Contact Sheet  (2024)
• Family Engagement Desk Guide (Child Contact Support Document 2024)
• Foster Care Frequently Asked Questions (FAQ)

Journey Placement Notebook

• Title/Cover Page
  • Introduction
• Reports and Document Divider
  • The Outcome Observation Report
• Forms Divider
  • Application for Youth Identification Card
  • Information Checklist
  • Wardrobe and Personal Inventory Checklist
  • Child's Daily Schedule
  • Medication Side Effects Checklist
  • Therapist/Healthcare/Service Providers
  • Equipment/Supplies Inventory
  • Foster Care Tuition Waiver Facts
• Terms/Information Guide Divider
  • Terms and Information
• Relative Letter
• Youth Transition Plan​

ICPC

• 100A Interstate Compact on Placement of Children Request (with instructions)
• 100B Interstate Compact on Placement of Children Report on Child's Placement Status  (rev 012020)
• Instructions for Completing ICPC 100B Report on Child's Placement Status  (rev012020)
• Case Worker Assignment Form
• Checklist for Home Studies  (August 2020)
• New ICPC Parent Placement Evaluation Template
• ICPC 101 Regulation 7 Combined
• ICPC 101 Regulation 7 Court Order Form Example
• ICPC-Tips-Reminders
• ICPC Residential Checklist  (2023)
• ICPC WVDHHR Financial and Medical Plan
• ICPC Regulation 2 Signed Statement
• Safe and Timely Progress Form
• Sample Child Summary
• Social Assessment
• Statement of Assurance
• Supervision Report Form

OUT OF STATE PROVIDER FORMS

• Critical Incident Report Form

PREVENTION SERVICES FORMS

• THRIVE Referral Form FFT West Virginia
• FFPSA UM Guidelines for Functional Therapy
• Healthy Families America (HFA) Enrollment Form
• FFPSA UM Guidelines for Health Families America
• Parent as Teachers (PAT) Enrollment Form
• FFPSA UM Guidelines for Parents as Teachers