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
Date of Birth*

MonthDayYear
Admission Date*

MonthDayYear
KK Number*
Medical Number*
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: