• 2026 Reimbursement Request

    Kinship Families Only

    Use this form only for CPR/First Aid reimbursements,  Dog Rabies Vaccine or Dog License reimbursements and Well Water Test reimbursements.

  • At this time, BOOST a FOSTER FAMILY only accepts referrals for not-yet-licensed KINSHIP families experiencing financial hardship or who have other barriers prohibiting them from becoming licensed or taking placement. 

    If you are the family filling out this form STOP RIGHT HERE and have your DCS or Agency Worker complete the form. If the family fills out this application, assistance will be denied.

    PLEASE NOTE: Boost a Foster Family will reimburse eligible families after they have acquired the service (CPR/1st Aid class, dog rabies vaccine/license or required well water testing). Boost will only reimburse actual costs up to the following limits: 

    • CPR/1st Aid - $65/person
    • Dog Rabies Vaccine (no other vaccines) - $42/dog
    • Dog License (tag not included) - $65/dog
    • Well Water Testing  - $225

    Itemized receipts must be uploaded in this form to receive reimbursement. 

    INSTRUCTIONS: 

    1. Family obtains service at a provider of their choice. (see recommendations to make sure provider/service meets all requirements)

    2. Family submits to you a copy of their itemized receipt.

    3. DCS/Agency Worker completes this form and uploads receipts. Receipts older than 60 days will NOT be reimbursed. 

    4. Boost a Foster Family mails a check to the family directly which may take up to two weeks to process.

  • Family Information

    Please provide the following data on the family in need of assistance (all entries are required):
  • Did you request other items for this family on a different form?*
  • Click all that apply
  •  -

  • Additional Required Information

  • Is this family Low-Income (less than twice the federal poverty threshold)*
  • List ALL Adults in the Home including adult children (more than 5 adults, please list data in Additional Info)*
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  • List ALL Children under 18 in the Home include those ALREADY PLACED and those AWAITING PLACEMENT. (more than 8 children, please list data in Additional Info)*
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  • Agency Information

  • I certify that I work for DCS, the Care Portal, CASA, a foster care licensing agency or other nonprofit agency in Arizona and that I am filling this out on the behalf of an Arizona family in need. 

    Boost counts on workers like you to determine which families truly need financial help. Because we care so much for families, we want to offer this to every family, but Boost will be able to help more needy families if you rule out families that can afford these services on their own. Help us by requesting for the families who truly need this assistance.

  •  -
  • I have gained permission to share identifying information with Boost a Foster Family*

  • Reimbursement Information

    CPR - $65/person | Dog Rabies Vaccine - $42/dog | Dog License - $65/dog | Well Water - $225/home
  • I am requesting reimbursement for (check all that apply):

  • CPR/First Aid Class

    Maximum reimbursement $65/person. 

    Boost will only reimburse for cost of Child/Infant/Adult-AED CPR & 1st Aid classes that are required for licensure by OLR. 

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  • Rabies Vaccinations

    Maximum reimbursement $42/dog 

    Boost will only reimburse for dog rabies vaccine. No other vaccines will be reimbursed. If the family opts for more vaccines, Boost will only reimburse the cost of the rabies portion. 

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  • Dog Licenses

    Maximum reimbursement $65/dog

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  • Well Water Tests

    Maximum reimbursement $225/home

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  • Please note: We commit to responding to this referral as soon as possible. Sometimes additional information is required in order to fulfill the order. If we do not receive the requested information within 90 days, this referral will expire. 

  • Reload

  • You will receive an email confimation after clicking SUBMIT. If you do not receive the email within a few minuntes, please check this page to make sure all the required fields have been completed. Contact us if you have futher problems.

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