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 5/22/2019) – PDF

All About Me Booklet – PDF

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

Application for Child Placement (8/2022) – PDF

Authorization for Release of Information (Revised 12/14/2023) – 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 2023 – PDF

Foster Parent Mileage Reimbursement Form 2022 – REVISED – PDF

Foster/Adoption Parent Caregiver Agreement – PDF

Medication Log (for Prescriptions) – PDF

Medical Statement for Foster Caregiver/Adoptive Applicant and All Household Members (Revised 8/2022) – PDF

Request to Release Social Security Number (Revised 2/11/2020) – PDF

Respite Care (Revised 6/2021) – 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