OAFC Placement Narrative

Placement Narrative
Issuing Office*

Oklahoma CityTulsaLawton
Preparer's Name
Preparer's Email
Enter Date

MonthDayYear
Childs First Name
Child's Last Name
Nickname
Admission Date

MonthDayYear
KK Number
Medical Number
Date of Birth

MonthDayYear
Age
Below is a description of the details of this youth's placement
Placement History:
Medical, Special Needs:
Summary of Events at Placement (i.e. Locations, Persons Involved)
Staff Signature*

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Signature Date

MonthDayYear
Should be Empty: