Assessor Forms

Below is a list of forms that may be needed by Adoption Workers in the field.

Applicant Financial Statement – PDF

Autobiography – PDF

Background Check – PDF

Caregiver Agreement for Discipline – PDF

Child Characteristic Checklist – PDF

Emergency Telephone numbers – PDF

Foster/Adoptive Family Agreement – PDF

Medical Statement for Foster Care and Adoptive Applicant – PDF

Reference Personal Questionaire – PDF

Adult Child Reference – PDF

Policy and procedure Acknowledgement – PDF

Release of Information – PDF

Reference Employer Form – PDF

Reference School Form – PDF

Safety Audit – PDF

Substitute W-9 Form for CSB Parent Applicant 1- PDF

Substitute W-9 Form for CSB Parent Applicant 2- PDF

Volunteer Reference – PDF

Support Our Mission

Learn how you can help advance the mission of Summit County Children Services

Foster or Adopt

With nearly 800 children in our custody, SCCS relies on the selflessness of our community to foster or adopt children in need.

Volunteer or Donate

We have year-round activities the success of which is dependent on the generosity of our community.

Diversity, Equity and Inclusion

Get the latest information about SCCS activities toward Diversity, Equity, and Inclusion.

Subscribe to SCCS Publications