Parent Questionnaire – DHHS - Foster Care Review Office

Parent Questionnaire – DHHS

"*" indicates required fields

User Information

What is reported in this questionnaire may be included in the local board’s report to the legal parties to the case.

Name of Parent*

First Last

Name of Child/ren

If responding for more than one child, use the oldest child’s first name and last initial.

Name of Child*

First Last (1st initial only)

Address

City State

Board #: If Known

Meeting Date: If Known

System Contact

How often do you have contact with your DHHS case manager?

Please share any positives and any concerns, if you have any, with your interactions with DHHS.

Are consistent and timely family team meetings taking place? Describe any barriers, if there are any, keeping you from attending team meetings.

What could DHHS and the Court do to meet your needs better?

Children

Tell us about your child/ren, such as their strengths, interests, positive and negative behaviors, etc.

What activities does your child/ren participate in with you as a family or in the school/community?

Does your child/ren need anything in order to be able to participate in these activities? Explain.

Visitation – Answer if your child/ren are placed outside of your home.

How often do you have visits with your child/ren?

How are visits going?

What would improve visits for you and your child/ren?

Services For You

What services are you participating in?

Are there any services you need that are not being offered? Explain.

Services For Your Child/ren

What services is your child/ren participating in?

Are there any services your child/ren needs that are not being offered? Explain.

Education

Where does your child/ren go to school/preschool/childcare?

How is your child/ren doing in school? (grades/progress, challenges etc.)

Describe any support or special education services your child/ren is receiving.

Are there any education supports your child/ren need that are not being provided? Explain.

Additional Information

Is there anything else you would like us to know?

Although not required, if you would like to submit any additional related documents you may do so below:

Accepted file types: pdf, xls, xlsx, doc, docx, jpg, png, gif, tiff, txt, Max. file size: 64 MB.

By returning this document, you confirm that this information is true and accurate and that you understand this information may be shared with the legal parties to the case..