• TARA HALL HOME FOR BOYS

    James E. Dumm, Jr. | Director
  • P.O. BOX 955, GEORGETOWN, SC 29442 | (843) 546-3000 | fax (843) 527-2156

  • APPLICANT INFORMATION

  • In order to adequately consider a youth for placement, we will need the following information:

    1. The Application
    2. Copy of the Court Order establishing custody of the youth. (only if court action has occurred)
    3. Results of recent psychological testing.
    4. School Records (attendance, grades, recent testing & behavior)
    5. Any - All behavioral health a ssessments

     

    If the youth is accepted into our program we will need the following information at admission time.

    1. Copy of current physical exam (within 6 months)
    2. Copy of immunization record
    3. Copy of Birth Certificate
    4. Copy of Social Security Card
    5. Insurance and/or Medicaid Card

    This information will greatly help us in planning when considering a youth’s application.

    Thank you for your cooperation!

    PF-15F

  • TARA HALL HOME FOR BOYS BASIC INFORMATION FORM

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    Pick a Date
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    Pick a Date
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  • Insurance Information

  • FAMILY INFORMATION

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  • Child's Siblings

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  • CHILD’S INFORMATION

  • Where has the youth lived within the past 5 years?

  • SCHOOL INFORMATION

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  • CHILD’S PERSONALITY & BEHAVIOR

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  • JUVENILE COURT SYSTEM INVOLVEMENT

  • List below any contacts with the court system. 

  • MEDICAL HISTORY


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  • PRE-NATAL & BIRTH INFORMATION

  • REFERRAL & TREATMENT

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