24-Hour Child Abuse and Neglect
(330) 434-KIDS (5437)

Summit County
Children Services

264 S. Arlington St.
Akron, OH 44306
Phone: 330.379.9094
Fax: 330.379.1901
Hearing Impaired: ORS 7-1-1

Foster Parent Forms

Below are frequently requested forms for the specific use by foster parents of Summit County Children Services. Click on the individual PDF links to access the forms.  Print and complete the forms and submit them to your Coordinator.

Advance Authorization for Out-of-County Travel with Medical Authorization (Revised 1/15/2016) - PDF

Applicant Financial Statement (5/6/2017) - PDF

Authorization for Release of Information (Revised 6/25/2016) - PDF

Background Check - PDF

Child Characteristics Checklist for Foster Care and/or Adoption - PDF

Clothing Checklist for SCCS - Foster Children - PDF

Foster Parent Mileage Reimbursement Form - PDF

Foster/Adoption Parent Caregiver Agreement - PDF

Medication Log (for Prescriptions) - PDF

Medical Statement for Foster Caregiver/Adoptive Applicant and All Household Members - PDF

Request to Release Social Security Number (Revised 12/14/2015) - PDF

Respite Program Information (Revised 2/27/2017) - PDF

SCCS Caregiver Agreement for Discipline, Care, Time-Out, and Prohibition of Seclusion & Restraint - PDF

Verification for Foster Parents - Employment and School for Caregivers  - PDF

Verification for Foster Parents - Day Care License Enrollment - PDF


Provider Respite Forms

JFS 01218 Basic Infant Information

JFS 01234 Child Enrollment and Health Information

JFS 01236 Child Care Plan for Health Conditions and Medical Procedures