All DFCS Forms
ADP 196 Affidavit of Consent to Adoption #1, 1 page, 71 KB
ADP 197 Affidavit of Consent to Adoption #2, 1 page, 91 KB
APS 174 APS Acknowledgement Letter, 1 page, 32 KB
APS 180 Guardianship Reporting Form, 1 page, 34 KB
APS 181 Guardianship Checklist, 2 pages, 48 KB
APS 182 Disabled Adult Abuse Report, 2 pages, 45 KB
APS 183 Personal Care Home Relocation Sheet, 2 pages, 63 KB
AA - Adoption Assistance for Independent Adoptions - Information for Adoptive Families
AA - IV-E Application for Adoption Assistance - Non DFCS Adoption
AA - IV-E Application for Adoption Assistance - Non-DFCS Adoption - Instructions
AA - Removal Home Income and Asset Checklist - Non-DFCS Adoption
AA - Removal Home Income and Asset Checklist - Non-DFCS Adoption - Instructions
AA - Authorization by Adoptive Parent for Payment of Non-Recurring Funds Directly to a Third Party
AA - IV-E Application for Adoption Assistance - Non DFCS Adoption
AA - IV-E Application for Adoption Assistance - Non-DFCS Adoption - Instructions
AA - Removal Home Income and Asset Checklist - Non-DFCS Adoption
AA - Removal Home Income and Asset Checklist - Non-DFCS Adoption - Instructions
AA - Authorization by Adoptive Parent for Payment of Non-Recurring Funds Directly to a Third Party
Spanish Version of Adoption Notice of Privacy
FORM 419 - Birth Family Background Information for Child, 7 pages, 599 KB
CPS 18 Sample Mandated reporter Letter, 1 page, 32 KB
CPS 187 CPS Intake Supervisory Case Review Guide, 1 page, 46 KB
CPS 188 CPS Investigation Supervisory Case Review Guide, 1 page, 61 KB
CPS 189 CPS Ongoing Supervisory Case Review Guide, 2 pages, 72 KB
CPS 19 Case Determination Letter #1, 1 page, 29 KB
CPS 198 Record of Reports, 1 page, 61 KB
CPS 198I Record of Reports Instructions, 1 page, 23.5 KB
CPS 20 Case Determination Letter #2, 1 page, 34.5 KB
CPS 21 Case Determination Letter #3, 1 page, 26.5 KB
CPS 22 Case Determination Letter #4, 1 page, 27 KB
CPS 23 Case Determination Letter #5 Substantiated, 1 page, 26.5 KB
CPS 23 Case Determination Letter #5 Unsubstantiated, 1 page, 26.5 KB
CPS 24 Response to Case Review Request, 1 page, 27.5 KB
CPS 25 Case Determination Letter #1 (Spanish), 1 page, 30.5 KB
CPS 26 Case Determination Letter #2 (Spanish), 1 page, 31 KB
CPS 27 Case Determination Letter #3 (Spanish), 1 page, 28 KB
CPS 28 Case Determination Letter #4 (Spanish), 1 page, 28 KB
CPS 29 Case Determination Letter #5 (Spanish) Substantiated, 1 page, 27 KB
CPS 29 Case Determination Letter #5 (Spanish) Unsubstantiated , 1 page, 27 KB
CPS 30 Response to Case Review Request (Spanish), 1 page, 29 KB
CPS 31 Nationwide CPS Alert Form, 2 pages, 43 KB
CPS 32 Child Fatality/Serious Injury Report, 2 pages, 45 KB
CPS 32 Child Fatality/Serious Injury Report Instructions, 3 pages, 18 KB
CPS 36 Open Record Act: Documentation of Request, 1 page, 39 KB
CPS 37 Letter to Person Requesting Record(s), 1 page, 28 KB
CPS 38 Early Intervention Letter-Family Notification, 1 page, 28 KB
CPS 387 Case Plan, 1 page, 36 KB
CPS 388 Goals and Steps, 2 pages, 46 KB
CPS 39 Early Intervention Letter-Provider Notification, 1 page, 29 KB
CPS 431 Child Abuse & Neglect Report, 3 pages, 174 KB.
CPS 431I Child Abuse & Neglect Report Instructions, 4 pages, 35 KB.
CPS 450 Basic Information Worksheet, 2 pages, 149 KB
CPS 453 CPS Intake Referral, 2 pages, 109 KB
CPS 453I CPS Intake Referral Instructions, 4 pages, 52 KB
CPS 454 Investigative Conclusion, 2 pages, 48 KB
CPS 454I Investigative Conclusion Instructions, 1 page, 22 KB
CPS 455A Safety Assessment, 2 pages, 161 KB
CPS 455AI Safety Assessment Instructions, 2 pages, 32 KB
CPS 455B Safety Plan, 1 page, 36 KB
CPS 455BI Safety Plan Instructions, 1 page, 20 KB
CPS 457 Risk Assessment, 1 page, 177 KB
CPS 457I Risk Assessment Instructions, 5 pages, 52 KB
CPS 458 Strengths and Needs, 2 pages, 74 KB
CPS 458I Strengths and Needs Instructions, 3 pages, 50 KB
CPS 460 Risk Re-Assessment, 1 page, 74 KB
CPS 460I Risk Re-Assessment Instructions, 1 page, 40 KB
Child Death/Serious Injury Supplemental Report, Microsoft Word Format, 36 KB
CW 0-2 Questionnaire For Determining Independent Contractor Status, 3 pages, 60 KB
CW 100 PUP/Homestead/Parent Aide Authorization, 2 pages, 92 KB
CW 101 PUP/Homestead/Parent Aide Cumulative Record, 2 pages, 95 KB
CW 13 HIPPA Notice of Privacy Practices, 3 pages, 47 KB
CW 34 DFCS Authorization To Accept Child For Short-term Emergency Care, 3 pages, 52 KB
CW 35 Termination of DFCS Responsibility for Sort-term Emergency Care, 2 pages, 40 KB
CW 451 TCM Consent, 1 page, 24 KB
CW 452 Contact Sheet, 1 page, 46 KB
CW 481 - Inter-County Service Transfer, 1 page, 30 KB.
CW 502 - Family Service Worker Monthly Activity Report, 1 page, 127 KB
CW 502I - Family Service Worker Monthly Activity Report Instructions, 1 page, 27 KB
CW 510 - Legal Services Request Report , 1 page, 35 KB
CW 530 TANF Home Visit Checklist Guide, 1 page, 47 KB
CW 530I - TANF Home Visit Checklist Guide Instructions, 1 page, 41 KB
CW 534 - Subpoena Form, 2 pages, 44 KB
CW 534I - Subpoena Form Instructions, 1 page, 21 KB
CW 562 - Referral For Family Services, 1 page, 46 KB
CW 562I - Referral For Family Services Instructions, 1 page, 34 KB
CW 563 - Family Service Worker Case Plan, 2 pages, 62 KB
CW 564 - Physical Examination, 1 page, 40 KB
CW 564A Physical Examination of Family Service Worker, 1 page, 33 KB
CW 565 - Family Service Worker Case Log, 2 pages, 127 KB
CW 566 - Family Service Quarterly Statistical Report, 1 page, 42 KB
CW 566I Family Service Quarterly Statistical Report Instructions, 1 page, 33 KB
CW 590 - Internal Data System, 2 pages, 91 KB.
CW 591A - Inventory Receipt Statement, 1 page, 54 KB
CW 713 - Inter-Office, 2 pages, 88 KB
CW Emergency Intake Form, 1 page, 87KB.
Microsoft Word Format, 526KB
FC 29 Foster Parent Child Safety Agreement, 2 pages, 50 KB
DFCS Forms Online Instructions, 14 pages, 680 KB.
ERF-1 Emergency Relocation Fund Approval Form, 1 page, 39 KB
ERF-2 Emergency Relocation Tracking Form, 1 page, 85 KB
FC 0-12 Awareness Statement, 1 page, 28 KB
FC 0-13 DFCS Foster Home Re-Evaluation, 10 pages, 252 KB
FC 0-16 Foster to Adopt 74 Agreement, 3 pages, 93 KB
FC 0-17 Face Sheet: DFCS Foster Home Initial Approval Data, 1 page, 55 KB
FC 0-18 Change In Foster Home Status, 1 page, 65 KB
FC 100A - Interstate Compact Placement Request, 1 page, 83 KB
FC 100AI - The Interstate Compact on the Placement of Children Request Insructions
FC 100B - Interstate Compact Report on Child's Placement Status, 1 page, 71.5 KB
FC 100BI - Interstate Compact Report on Child's Placement Status Instructions, 1 page, 27 KB
FC 101 Interstate Compact on the Placement of Children Sending State Priority Home Study Request, Microsoft Word fomat, 28 KB
FC 101I Interstate Compact on the Placement of Children Send State Priority Home Study Request Instructions, 31 KB
FC 11 Acknowledgement of DFCS Driving Policy, 1 page, 28 KB
FC 118 Termination Packet (Termination Questionnaire and Reporting Forms), 6 pages, 115 KB
FC 118I Termination Packet Instructions, 1 page, 20 KB
FC 122 Foster Care Referral, 1 page, 51 KB
FC 122I Foster Care Referral Instructions, 2 pages, 23 KB
FC 124 JJ Letter, 1 page, 31 KB
FC 129 Request For Administrative Hearing, 1 page, 45 KB
FC 130 Waiver To Administrative Hearing, 1 page, 29 KB
FC 131 OSAH Form 1, 1 page, 30 KB
FC 132 Non Objection To Subsequent Release of Information By Primary Source, 1 page, 28 KB
FC 141 Notification For Change In Case Plan/Services, 1 page, 47 KB
FC 149 Notification to Foster Parents of Intent To Petition For TPR, 1 page, 45 KB
FC 149I Notification to Foster Parents of Intent To Petition For TPR Instructions, 1 page, 22 KB
FC 150 Foster Parents Affidavit For Consideration of Adopting Foster Child Currently in Home, 2 pages, 73 KB
FC 150I Foster Parents Affidavit For Consideration of Adopting Foster Child Currently in Home Instructions, 1 page, 22 KB
FC 151 Foster Parents Notification of Decision Regarding Adopting Foster Child Currently in Home, 1 page, 50 KB
FC 151I Foster Parents Notification of Decision Regarding Adopting Foster Child Currently in Home Instructions, 1 page, 26 KB
FC 166 - RT MATCH Profile Instrument (Part 1), 7 pages, 317 KB
FC 191 Placement Services Supervisory Case Review Guide, 2 pages, 111 KB
FC 192 CPRS Supervisory Review of Case Plan, 88KB.
FC 200 - Foster Home Review Guide, 3 pages, 61 KB
FC 201 Children Free For Adoption, 3 pages, 64 KB
FC 223 Medicaid and IV-E Application for Foster Care, 1 page, 74 KB
FC 223 Instructions. Microsoft Word format, 26KB.
FC 224 Removal Home Income and Asset Checklist, 1 page, 55 KB
FC 224 Instructions. Adobe Acrobat format, 26KB.
FC 227 Notification of Change in IV-E Statusinstructions, 1 page, 27 KB
FC 227 Notification of Change in IV-E Status, 1 page, 49 KB
FC 271 Placement of Non-Special Needs Child, 1 page, 48 KB
FC 316 - Unreimbursed Routine Substitute In-Home - Out-of-Home Caregivers
Adobe Acrobat format, 35KB.
Adobe Acrobat format, 35KB.
FC 316I - Unreimbursed Routine Substitute In-Home - Out-of-Home Caregivers Instructions
Adobe Acrobat format, 26KB.
Adobe Acrobat format, 26KB.
FC 3267 - Children 1st Screening and Referral Form, 2 pages, 189 KB
FC 3267 Children 1st Screening and Referral Form Instructions, 7 pages, 163 KB
FC 38 Agreement Between Foster family and County DFCS, 3 pages, 57 KB
FC 40 Agreement Supplement, 1 page, 39 KB
FC 448 - Institutional Placement Agreement, 2 pages, 52 KB
FC 469 - Foster Child Information Sheet, 1 page, 33 KB
FC 5 - Voluntary Agreement To Place Child In Foster Care, 2 pages, 57 KB
FC 526 Foster Care Invoice, 1page, 96 KB
FC 526I - Foster Care Invoice Instructions, 1 page, 25 KB
FC 527 - Initial Authorization of Foster Careinstructions, 1 page, 32 KB
FC 527 - Initial Authorization of Foster Care, 1 page, 52 KB
FC 529 Authorization of Foster Care Status Change/Termination Instructions, 1 page, 32KB
FC 529 Authorization of Foster Care Status Change/Termination, 1 page, 51 KB
FC 530 Subpoena For the Production of Documentary Evidence, 1 page, 37 KB
FC 6 - Foster Family Home Placement Agreement Between County DFCS, 1 page, 51 KB
FC 7 - Consent To Remain In Foster Care, 1 page, 32 KB
FC 750 - Authorization For Restricted Funds, 1 page, 43 KB
FC 750I Authorization For Restricted Funds Instructions, 1 page, 22 KB
FC 80 Request for Step I Foster Parent Grievance Meeting, 1 page, 30KB.
FC 81 Step I Foster Parent Grievance Procedure Report, 1 page, 37KB.
FC 82 Request for Step II Foster Parent Grievance Meeting, 1 page, 32KB.
FC 83 Step II Foster Parent Grievance Procedure Report, 1 page, 38KB.
FC 84 Request for Step III Foster Parent Grievance Meeting, 1 page, 32KB.
FC_99 Interstate Compact on the Placement of Children Financial Medical Plan, Microsoft Word Format, 28 KB
FC_99 Interstate Compact on the Placement of Children Financial Medical Plan Instructions, Microsoft Word Format, 28 KB
FORM 0-1 Independent Contractor Proposal Foster/Adoptive Parent Co-Leader GPS: MAPP, 1 page, 28 KB
FORM 0-10 Securing GCIC and FBI Criminal Record Checks, 1 page, 24 KB
FORM 0-10I Securing GCIC and FBI Criminal Record Checks Instructions, 1 page, 23 KB
FORM 0-17I Face Sheet: DFCS Foster Home Initial Approval Data Instructions, 1 page, 30 KB
FORM 0-18I Change in Foster Home Status Instructions, 1 page, 24 KB
FORM 0-1 Independent Contractor Proposal Foster/Adoptive Parent Co-Leader GPS: MAPP Instructions, 1 page, 24 KB
FORM 3 Voluntary Agreement To Place Child in Foster Care (Adoption Planning), 2 pages, 48 KB
FORM 31 Placement Origin, 1 page, 36 KB
FORM 33 Placement Agreement (Single Child), 1 page, 38 KB
Spanish Version of Form 35, 120 KB
Form 35 - Application for Adoption, 2 Pages, 131 KB
FORM 35I Application To Adopt or Foster Instructions, 1 page, 20 KB
Spanish Version of Form 36, 99 KB
FORM 36 Medical Report, 3 pages, 97 KB
FORM 37 Placement Agreement (Siblings), 1 page, 37 KB
FORM 385 APS Intake Form, 2 pages, 70 KB
FORM 385A APS Assessment, 2 pages, 225 KB
FORM 385I APS Intake Form Instructions, 4 pages, 37 KB
FORM 386 APS Determination, 2 pages, 45 KB
FORM 387I Case Plan Instructions, 2 pages, 32 KB
FORM 400 Child Registration, 2 pages, 162 KB
FORM 400I Child Registration Instructions, 1 page, 49 KB
FORM 401 Family Registration, 2 pages, 141 KB
FORM 401I Family Registration Instructions, 1 page, 49 KB
FORM 403 Adoption Assistance Memorandum, 2 pages, 152 KB
FORM 404 Consent For Criminal Records Check, 1 page, 34 KB
FORM 405 Purchase of Service Agreement - Placement, 2 pages, 39 KB
FORM 409 Name Change Following Adoption, 1 page, 35 KB
FORM 414 Placement Letter, 1 page, 43 KB
Spanish Version of Form 419, 120 KB
FORM 43 Affidavit of Disclosure, 2 pages, 78 KB
FORM 432 Child's Life History Checklist/Registration Cover Letter, 1 page, 140 KB
Spanish Version of Form 44, 135 KB
FORM 44 Financial Statement, 2 pages, 63 KB
FORM 45 Relative Care Subsidy Agreement, 1 page, 71 KB
FORM 51 Relative Care Subsidy Annual Renewal Report, 4 pages, 108 KB
FORM 535 Authorization and Claim for Psychological, Psychiatric and Speech Therapy Services , 3 pages, 94 KB
FORM 5357 Bill For Services Rendered, 2 pages, 164 KB
Spanish Version of Form 5459R, 97.5 KB
FORM 5459R Authorization for Release of Information (Resource Families), 1 page, 99KB
FORM 5459R Authorization For Release of Information, 100 KB
FORM 5459R Authorization For Release of Information Instructions, 11 pages, 119 KB
Spanish Version of Form 553, 54 KB
FORM 553 Biological Parent Affidavit of Non-Disclosure, 1 page, 60 KB
FORM 560 Adoption Assistance Fact Sheet, 1 page, 28 KB
Spanish Version of Form 561, 69.5 KB
FORM 561 Biological Parent Consent To Contact, 1 page, 78 KB
FORM 565I Family Service Gorker Case Log Instructions, 1 page, 34 KB
Spanish Version of Form 572, 36.5 KB
FORM 572 Surrender (Biological not Legal Father), 1 page, 39 KB
FORM 572I Surrender (Biological not Legal Father) Instructions, 1 page, 22 KB
Spanish Version of Form 573, 36.5 KB
FORM 573 Surrender (Parent), 1 page, 36 KB
FORM 573I Surrender (Parent) Instructions, 1 page, 22 KB
FORM 574 Grandparent Acknowledgement, 2 pages, 50 KB
FORM 574I Grandparent Acknowledgement Instructions, 1 page, 24 KB
Spanish Version of Form 576, 39 KB
FORM 576 Affidavit of Department Representative, 1 page, 36 KB
FORM 576I Affidavit of Department Representative Instructions, 1 page, 22 KB
Spanish Version of Form 577, 31.5 KB
FORM 577 Acknowledgement of Surrender, 1 page, 36 KB
FORM 577I Acknowledgement of Surrender Instructions, 1 page, 21 KB
Spanish Version of Form 578, 145 KB
FORM 578 Mother's Affidavit, 4 pages, 131 KB
FORM 578I Mother's Affidavit Instructions, 1 page, 22 KB
FORM 579 Adoptive Mother's Affidavit, 2 pages, 105 KB
FORM 579I Adoptive Motherss Affidavit Instructions, 1 page, 21 KB
Spanish Version of Form 580, 36.5 KB
FORM 580 Denial/Disclaimer/Surrender, 1 page, 40 KB
FORM 580I Denial/Disclaimer/Surrender of Rights Final Release for Adoption Instructions, 1 page, 21 KB
FORM 581 Withdrawal of Surrender, 1 page, 34 KB
FORM 581I Withdrawal of Surrender Instructions, 1 page, 20 KB
FORM 591B Electronic Benefit Transfer Receipt, 1 page, 48 KB
FORM 6036 Family Approval/Registration Cover Letter, 2 pages, 66 KB
FORM 6036I Family Approval/Registration Cover Letter Instructions, 1 page, 22 KB
Microsoft Word Format, 60KB
FORM N-4 Corrective Action Plan, 3 pages, 59 KB
FORM N-4I Corrective Action Plan Instructions, 1 page, 29 KB
FORM N-6 Report Of Policy Violation In Agency Foster Homes, 1 page, 27 KB
FORM N-6I Report Of Policy Violation In Agency Foster Homes Instructions, 1 page, 24 KB
FORM N-7 Format For Report Of Policy Violation(s) in Agency Foster Homes, Foster/Adoptive Homes and Adoptive Homes, 1 page, 28 KB
FORM N-9 State Office Response, 1 page, 26 KB
FORM N-9I State Office Response Instructions, 1 page, 24 KB
FPBP 157 Pre-Evaluation Checklist, 1 page, 33 KB
FPBP 157I Pre-Evaluation Checklist Instructions, 1 page, 21 KB
FPBP 161 FPBP Assessment Invoice, 2 pages, 52 KB
FPBP 161I FPBP Assessment Invoice Instructions, 3 pages, 36 KB
FPBP 164 Wrap Around Services Invoice, 1 page, 62 KB
FPBP 164I Wrap Around Services Invoice Instructions, 2 pages, 34 KB
FPBP 165 Quarterly Report, 1 page, 33 KB
FPBP 3 MDT Staffing Recommendation Form, 3 pages, 44 KB
FPBP 3I MDT Staffing Recommendation Form Instructions, 1 page, 24 KB
FPBP 4 Assessment Waiver Request Form, 1 page 28 KB
FPBP 4I Assessment Waiver Request Form Instructions, 2 pages, 24 KB
FPBP 5 Wrap Around Services Authorization, 2 pages, 87 KB
FPBP 5I Wrap Around Services Authorization Instructions, 3 pages, 27 KB
FPBP 6 Referral For Wrap Around Services, 1 page, 55 KB
FPBP 7 Assessment Summary Cover Sheet, 1 page, 40 KB
FS 152 Application For Handicapped Parking, 1 page, 49 KB
Instructions for Completing Foster Parent Re-Evaluation Form 0-13
Adobe Acrobat format, 35KB.
Adobe Acrobat format, 35KB.
Microsoft Word Document, 43KB
Its My Turn Now Georgia Descriptive Summary, 3 pages, 76 KB
Microsoft Word format, 23 KB
Microsoft Word Format, 38 KB
Microsoft Word Format, 46 KB
Microsoft Word format, 54.5 KB
RD 120 Quarterly Recruitment and Statistical Report, 3 pages, 97 KB
RD 133 Annual Recruitment Plan - Example and Format, 2 pages, 41 KB
RD 190 Foster Family Assessment Supervisory Case Review Guide, 1 page, 54 KB
RT 166I MATCH Profile Instrument Instructions, 2 pages, 28 KB
RT 167 MATCH Checklist, 2 pages, 63 KB
RT 168 Statement of Educational Services, 1 page, 31 KB
RT 169 Placement Efforts and Results, 1 page, 33 KB
RT 170 Agreement Regarding Application To The MATCH (Part A), 1 page, 29 KB
RT 171 MATCH Agreement For Case Manager's Supervisor and Next Level Administrator (Part B), 1 page, 26 KB
RT 172 MATCH Agreement For A Child In the Custody of Parent/Legal Guardian (Part C), 1 page, 28 KB
RT 173 County Codes, 1 page, 56 KB
SI 153 Special Investigations Cover Memorandum, 1 page, 27 KB
SI 154 Special Investigation Summary Report Of A Home Approved For Child In Custody Of DFCS/DHR, 1 page, 29 KB
SI 155 Special Investigation Summary Report Of A Facility Approved For Child In Custody Of DFCS/DHR, 2 pages, 28 KB
SI 156 Facility/Agency Determination Letter, 1 page, 31 KB