Intake Questionnaire
Applicant Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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What sparked your interest in wanting to become a Foster Parent?
Tell us about you, family, employment, etc.
In the Job Description for becoming a Foster Parent, you must be able to transport or have access to reliable transportation for any appointments related to medical or school for the child placed in your home. Will this be a problem for you?
Our agency is required to conduct background checks on each applicant and adult household member. Is there any information that may be on your background check or any other adults within your household that will raise questions or need to be explained?
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Have you been a Foster Parent before? If so, how long ago and with which agency(s)?
If a transfer applicant, why do they want to transfer from the previous agency?
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Do you have experience working with children/adolescents with behaviors?
Family Foster are children placed out of their biological home due to unfortunate circumstances and DSS custody. Therapeutic Foster care is when children are placed out of their biological home for residential treatment and have mental health diagnoses and behaviors that vary per child. Do you have a preference for which you would like to work with, or does it matter?
Do you have a preference in age or gender to work with? Yes/No
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Do you have any questions?
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