The_Reunification_Project_Intake

Family Intake & Advocacy Request Form

Thank you for reaching out to The Reunification Project. This form helps us understand your case and how we can support you through advocacy, education, and legal navigation. Please complete all sections.

Section 1: Contact Information
Full Name
Phone Number
Format: (000) 000-0000.
Email Address
example@example.com
City State
Preferred Method of Contact (Phone / Email / Text)
Format: (000) 000-0000.
Are your children currently in custody of DCFSCPS YesNo
Date of Removal if applicable

MonthDayYear
Date
Agency Handling Your Case
Current Caseworker Name Contact
Do you have an attorney YesNo
Attorney Name Contact if yes
Briefly describe what led to your case being opened
List services completed voluntary or courtordered
What is your desired outcome from The Reunification Projects support
Section 4: Document Submission

Please attach any relevant documents (court orders, case notes, service plans, etc with your submission.

Do you give permission for The Reunification Project to contact you regarding your case and use anonymized details for advocacy purposes?
File Upload

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Signature

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Date

MonthDayYear
Date
Should be Empty: