Foster Care Application

A New Leaf Foster Care Licensing Intake

Our goal is to ensure that foster parents feel welcomed and supported at A New Leaf’s Foster Care Program. Diversity, equity, inclusion, and justice are crucial elements for reaching our full potential and building a stronger community.
What type of care are you looking to provide?*

Family Foster Home (FFH)Adoption OnlyTherapeutic Foster Care (TFC)KinshipRespiteUnsure/need more information
A New Leaf is no longer contracted for Kinship Foster Care. Please reach out to DCS for an appropriate referral. If you are not receiving a response from your assigned DCS Case Manager, please email LEAH.REACH@AZDCS.GOV Our apologies for this inconvenience!
Name*

First NameMiddle NameLast Name
Preferred Name (If applicable)
Preferred Pronouns *
Preferred Language*
Gender*
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you lived in Arizona?*

Less than 5 YEARSMore than 5 YEARS
What state(s) have you lived in within the last 5 years, aside from AZ?*
Do you currently have a Level 1 Fingerprint Clearance Card?*

YesNo
Have you ever been arrested?*

YesNo
CRIMINAL HISTORY*

Relationship Status*
Parent B Information
Name*

First NameMiddle NameLast Name
Preferred Name (If applicable)
Preferred Pronouns *
Preferred Language*
Gender*
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
How long have you lived in Arizona?*

Less than 5 YEARSMore than 5 YEARS
Do you currently have a Level 1 Fingerprint Clearance Card?*

YesNo
Have you ever been arrested?*

YesNo
CRIMINAL HISTORY*

FAMILY INFORMATION
Do you have any children under the age of 18?*

YesNo
MINOR CHILD INFORMATION*
Do you have any children OVER the age of 18?*

YesNo
ADULT CHILD INFORMATION*
Have you ever had any DCS investigations?*

YesNo
DCS INVESTIGATIONS*
Are there any other adults living in your home?*

YesNo
ADULT HOUSEHOLD MEMBER INFORMATION*
LICENSING HISTORY

To be filled out with partner/spouse (if applicable)
Have you ever been licensed for foster care?*

YesNo
If yes, which Agency?*
HOME DETAILS

Please answer these questions about your home where a foster child would be living.
What type of home do you have?*

Single Family HomeApartment/ Condo/ TownhomeMobile HomeOther
Number of bedrooms*
Number of bathrooms*
Would a foster child be sharing a bedroom?*

YesNoUnsure
Do you have a pool/spa? (single family home only)*

YesNo
Do you have any pets?*

YesNo
PET INFORMATION*
Do you own any weapons/firearms?*

YesNo
If yes, are you willing to comply with the required safeguard procedures?*

YesNo
Does anyone in the home smoke/use tobacco?*

YesNo
TRANSPORTATION INFORMATION

Please answer these questions about your vehicles.
CAR INFO*
Are you willing to provide/acquire legally required infant/child car seats or booster chairs needed for placements if you will be fostering ages 5 and under?*

YesNo
Do you have any questions, comments, or concerns about A New Leaf Foster Care?*
How did you hear about us?*
If you selected friend, please share their name:*
If you heard about us from social media, which website?*
Take a moment to review your answers before submitting!

A member of our team will reach out to you soon for an intake interview, to review this questionnaire, and to go over the next steps.
Any questions: please email fostercareadoption@turnanewleaf.org or call our Program Manager at 480-825-6564.
***FOR A NEW LEAF USE ONLY***
What is your motivation for wanting to become licensed for foster care?
Do you have any worries/concerns about pursuing foster care/adoption?
Is your job/lifestyle flexible enough to accommodate different appointments for your foster child?
How do you feel about supporting child visitation with biological parents and siblings?
Have you talked to the important people in your lives about wanting to foster?
How do you feel about interacting with all those involved with the foster child such as DCS, biological parents, the court system, attorneys, and case aides?
What family supports do you currently have? Can any of these supports provide care temporarily if needed?
What are your plans for childcare while you are at work?
What discipline techniques are used or will be used in the home?
How would you support the cultural needs of a child of a different race, religion, or culture than your own?
Are there any behavioral challenges or known histories that you would not be willing to accept with a placement?
Should be Empty:

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A New Leaf Foster Care Licensing Intake

Parent B Information

FAMILY INFORMATION

LICENSING HISTORY

HOME DETAILS

TRANSPORTATION INFORMATION

Take a moment to review your answers before submitting!

***FOR A NEW LEAF USE ONLY***

FOR A NEW LEAF USE ONLY