Forms

Below are some downloadable forms that you may find very useful. They are not currently interactive meaning that you'll have to print them out for them to be of use, but within the week they'll be updated so that you'll be able to fill them out online.

You'll need the free Adobe Acrobat Reader in order to view the files. You can download it here, if you don't already have it installed.

 

Hit the back button to get back to this screen after viewing and completing
the selected form.

Forms:

Daily Behavior Log

Medication Log

Respite Care Report

Census Report

Dental Exam Form

Physical Exam Form

Optical Exam Form

Psychiatry Exam Form 

 

 

  1. Daily Behavior Log
    1. Use this document to help you monitor a child's daily progress and behavior
    2. Turn this document in with your monthly census sheet
    3. It is required that you fill out this form for all children placed in your home
  2. Medication Log
    1. Use this document to help you monitor a child's medication intake
    2. Turn this document in with your monthly census sheet
    3. It is required that you fill out this form for all children on medication in your home
  3. Respite Care Report
    1. Use this document whenever you care for a child in your home on a respite basis
    2. Remember you must also complete daily behavior logs for these children as well
    3. Return this form with the staff person returning your child from respite
  4. Census Report
    1. Fill out this form at the completion of every month and forward it to the fiscal department for reimbursement

These forms can be completed online and printed. Just choose the Hand Tool and click on a field that needs to be completed. You can use the Tab key on your keyboard to easily move from one field to the next. When you are finished, print the form. If you have the full version of Adobe Acrobat (not the free Reader), you can use the "save as…" option to save the file to disk or your hard drive. Please note that the "save a copy" option in the free Reader will save a copy of your form but will not save the field data that you filled in.