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Instructions Title​ Type Posted
  • APS-0001
    Authorization for Adult Maltreatment Central Registry
    		DOC05/29/2009
  • CFS-0365
    Receipt for Medical Passport of a foster child and acknowledgement of confidential nature of information contained in the Medical Passport.
    		DOC04/12/2011
  • CFS-0001
    Referral for Transitional Services & Support
    		DOC01/01/2011
  • CFS-0003
    Checklist for Youth Exiting Care
    		DOC01/01/2011
  • CFS-0035
    TYS Coordinator Monthly Summary
    		DOC01/01/2011
  • CFS-1136
    DCFS Employee Orientation Checklist Addendum
    		DOC09/01/2008
  • CFS-0203-A
    Notice of Child Maltreatment Allegation to Facility Director
    		DOC03/16/2011
  • CFS-0212-A Spanish
    Notice of Child Maltreatment Allegation to Alleged Offender (Spanish)
    		DOC08/01/2009
  • CFS-0212-A
    Notice of Child Maltreatment Allegation to Alleged Offender
    		DOC08/01/2009
  • CFS-0214-R
    Notice of Child Maltreatment Allegation to Employer, Entity in Charge of Paid or Volunteer Activity, or Licensing or Registering Authority
    		DOC03/16/2011
  • CFS-0214-R1
    Follow-up Notice to Employer or Volunteer Coordinator, or Licensing or Registering Authority Regarding Child Maltreatment Allegation
    		DOC03/16/2011
  • CFS-0215-R
    Risk Determination of Child(ren) under Care of Alleged Offender
    		DOC03/16/2011
  • CFS-0221-T
    Child Maltreatment True Investigative Determination Notice to Law Enforcement and Prosecuting Attorney
    		DOC03/16/2011
  • CFS-0225-T1
    Child Maltreatment True Investigative Determination Notice to Victim, Legal Parent(s), and Legal Guardian(s) of the Alleged Victim
    		DOC08/01/2009
  • CFS-0226-T1
    Child Maltreatment True Investigative Determination Notice to Circuit Judge, Attorney Ad Litem, CASA, and Counsel in Dependency Neglect or FINS Case of Alleged Victim
    		DOC09/19/2011
  • CFS-0228-T
    Child Maltreatment True Investigative Determination Notice to Attorney Ad Litem and CASA of Alleged Offender
    		DOC09/19/2011
  • CFS-0229-T
    Child Maltreatment True Investigative Determination Notice to Attorney Ad Litem and CASA for Child in Foster Home Where Maltreatment Is Reported
    		DOC09/19/2011
  • PDF01/01/2011
  • PDF09/01/2008
  • PDF08/01/2009
  • PDF08/01/2009
  • PDF11/01/2005
  • PDF11/01/2005
  • PDF03/16/2011
  • PDF10/26/2010
  • PDF10/29/2009
  • PDF04/13/2010
  • PDF06/01/2009
  • PDF03/16/2011
  • PDF02/01/2011
  • PDF02/01/2011
  • PDF03/16/2011
  • PDF08/01/2009
  • PDF08/15/2009
  • PDF03/16/2011
  • PDF08/01/2010
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF06/10/2010
  • PDF03/16/2011
  • PDF04/09/2007
  • PDF02/01/2008
  • PDF11/01/2010
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF01/13/2010
  • PDF03/16/2011
  • PDF03/01/2008
  • PDF03/16/2011
  • PDF10/01/2005
  • PDF04/01/2013
  • PDF04/01/2013
  • PDF03/16/2011
  • PDF08/01/2007
  • PDF08/01/2007
  • PDF11/01/2007
  • PDF06/01/2007
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF01/01/2011
  • PDF02/01/2005
  • PDF03/01/2008
  • PDF02/01/2005
  • PDF03/16/2011
  • PDF09/01/2003
  • PDF03/16/2011
  • PDF11/02/2009
  • PDF02/01/2005
  • PDF11/02/2009
  • PDF10/01/2010
  • PDF03/16/2011
  • PDF11/06/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF09/01/2007
  • PDF03/16/2011
  • PDF07/01/2006
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • DOC01/01/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF06/21/2010
  • PDF06/21/2010
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF12/14/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF08/01/2009
  • PDF12/04/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF12/14/2009
  • PDF03/16/2011
  • PDF08/01/2009
  • PDF04/13/2010
  • PDF08/01/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF08/01/2009
  • PDF08/01/2009
  • PDF08/01/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF12/14/2009
  • PDF08/01/2009
  • PDF12/04/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF08/01/2009
  • PDF08/01/2009
  • PDF08/01/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF12/14/2009
  • PDF08/01/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF08/01/2009
  • PDF08/01/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF12/14/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF10/01/2010
  • PDF12/04/2009
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • PDF03/16/2011
  • CFS-0230-T
    Child Maltreatment True Investigative Determination Notice to DHS Division Director; Coordinator of Multidisciplinary Team for Alleged Victim or Offender; and Circuit Judge and Counsel in Dependency Neglect or FINS Case for Alleged Offender
    		PDF09/19/2011
  • CFS-0231-T
    Child Maltreatment True Investigative Determination Notice to School Where Victim Is Enrolled
    		DOC09/19/2011
  • CFS-0232-T EH
    Expedited Hearing Request
    		DOC08/01/2009
  • CFS-0232-T PH
    Request for Preliminary Administrative Hearing
    		DOC08/01/2009
  • CFS-0232-T1 A Spanish
    Witness Statement of Notice of Investigative Determination (Spanish)
    		DOC08/01/2009
  • CFS-0232-T1 A
    Witness Statement of Notice of Investigative Determination
    		DOC08/01/2009
  • CFS-0232-T1 Spanish
    Child Maltreatment True Investigative Determination Notice to Alleged Offender (Spanish)
    		DOC08/01/2009
  • CFS-0232-T1
    Child Maltreatment True Investigative Determination Notice to Alleged Offender
    		DOC04/13/2010
  • CFS-0232-T2 Spanish
    True But Exempt Child Maltreatment Investigative Determination Notice to Offender (Spanish)
    		DOC08/01/2009
  • CFS-0233-T Spanish
    Child Maltreatment Expedited Hearing Notice to Alleged Offender (Spanish)
    		DOC08/01/2009
  • CFS-0233-T
    Child Maltreatment Expedited Hearing Notice to Alleged Offender
    		DOC08/01/2009
  • CFS-0234-T
    Child Maltreatment True Investigative Determination Notice to Licensing or Registering Authority and Employer or Entity in Charge of Paid or Volunteer Activity
    		DOC09/19/2011
  • CFS-0241-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Law Enforcement and Prosecuting Attorney
    		DOC08/01/2009
  • CFS-0242-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Licensing or Registering Authority
    		DOC09/19/2011
  • CFS-0243-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Facility Director
    		DOC09/19/2011
  • CFS-0244-U
    Offer of Supportive Services as a Result of Unsubstantiated Child Maltreatment Investigative Determination to Legal Parent(s) and Legal Guardian(s) of Alleged Offender
    		DOC09/19/2011
  • CFS-0245-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Legal Parent(s), Legal Guardians, and Current Foster Parents of the Alleged Victim
    		DOC08/01/2009
  • CFS-0245-U1
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Alleged Victim
    		DOC08/01/2009
  • CFS-0246-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Circuit Judge, Attorney Ad Litem, CASA, and Counsel in Dependency Neglect or FINS Case of Alleged Victim
    		DOC09/19/2011
  • CFS-0248-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Attorney Ad Litem and CASA for Alleged Offender
    		DOC09/19/2011
  • CFS-0249-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Attorney Ad Litem and CASA of Child in Foster Home Where Maltreatment Is Reported
    		DOC09/19/2011
  • CFS-0250-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to DHS Division Director; Coordinator of Multidisciplinary Team for Alleged Victim or Offender; and Circuit Judge or Counsel in Dependency Neglect or FINS Case for Alleged Offender
    		PDF09/19/2011
  • CFS-0252-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Alleged Offender
    		DOC08/01/2009
  • CFS-0253-U Spanish
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Mandated Reporter (Spanish)
    		DOC12/04/2009
  • CFS-0253-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Mandated Reporter
    		DOC12/04/2009
  • CFS-0254-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Alleged Offender’s Employer or Entity in Charge of Alleged Offender’s Paid or Volunteer Activity; or Licensing or Registering Authority
    		PDF08/01/2009
  • CFS-0261-O
    Notice of Overturned True Child Maltreatment Investigative Determination to Law Enforcement and Prosecuting Attorney
    		DOC08/01/2009
  • CFS-0263-O
    Notice of Overturned True Child Maltreatment Investigative Determination to Facility Director
    		DOC08/01/2009
  • CFS-0264-O
    Notice of Overturned True Child Maltreatment Investigative Determination to Legal Parent(s) and Legal Guardian(s) of the Alleged Offender
    		DOC08/01/2009
  • CFS-0265-O1
    Notice of Overturned True Child Maltreatment Investigative Determination to Victim and Legal Parent(s) and Legal Guardian(s) of Alleged Victim
    		DOC08/01/2009
  • CFS-0265-O2
    Notice of Overturned True Child Maltreatment Investigative Determination to Current Foster Parent(s) of the Alleged Victim
    		DOC08/01/2009
  • CFS-0266-O
    Notice of Overturned True Child Maltreatment Investigative Determination to Circuit Judge, Attorney Ad Litem, CASA, and Counsel in Dependency Neglect or FINS Case of Alleged Victim
    		DOC08/01/2009
  • CFS-0268-O
    Notice of Overturned True Child Maltreatment Investigative Determination to Attorney Ad Litem and CASA of Alleged Offender
    		PDF08/01/2009
  • CFS-0269-O
    Notice of Overturned True Child Maltreatment Investigative Determination to Attorney Ad Litem and CASA of Child in Foster Home Where Maltreatment Is Reported
    		DOC08/01/2009
  • CFS-0270-O
    Notice of Overturned True Child Maltreatment Investigative Determination to DHS Division Director; Coordinator of Multidisciplinary Team for Alleged Victim and Offender; and Circuit Judge and Counsel in Dependency Neglect or FINS Case of Alleged Offender
    		DOC12/14/2009
  • CFS-0272-O
    Notice of Overturned True Child Maltreatment Investigative Determination to Alleged Offender
    		DOC08/01/2009
  • CFS-0274-O
    Notice of Overturned True Child Maltreatment Investigative Determination to Licensing or Registering Authority and Employer or Entity in Charge of Paid or Volunteer Activity
    		DOC08/01/2009
  • CFS-0275-O
    Notice of Overturned True Child Maltreatment Investigative Determination to Child Safety Center Involved in Investigation of Maltreatment
    		DOC08/01/2009
  • CFS-0281-N
    Notice of Name Placement on Central Registry to Law Enforcement and Prosecuting Attorney
    		DOC08/01/2009
  • CFS-0283-N
    Notice of Name Placement on Central Registry to Facility Director
    		DOC08/01/2009
  • CFS-0284-N Spanish
    Notice of Name Placement on Central Registry to Legal Parent(s) and Legal Guardian(s) of the Juvenile Offender (10 to 17 Years of Age) (Spanish)
    		DOC09/19/2011
  • CFS-0284-N
    Notice of Name Placement on Central Registry to Legal Parent(s) and Legal Guardian(s) of the Juvenile Offender (10 to 17 Years of Age)
    		DOC09/19/2011
  • CFS-0285-N
    Notice of Name Placement on Central Registry to Victim, Legal Parent(s), Legal Guardian(s), and Current Foster Parent(s) of Victim
    		DOC08/01/2009
  • CFS-0286-N
    Notice of Name Placement on Central Registry to Circuit Judge, Attorney Ad Litem, CASA, and Counsel in Dependency Neglect or FINS Case of Victim
    		DOC08/01/2009
  • CFS-0288-N
    Notice of Name Placement on Central Registry to Attorney Ad Litem and CASA of Offender
    		DOC08/01/2009
  • CFS-0289-N
    Notice of Name Placement on Central Registry to Attorney Ad Litem and CASA of Child in Foster Home Where Maltreatment Is Reported
    		DOC08/01/2009
  • CFS-0290-N
    Notice of Name Placement on Central Registry to DHS Division Director; Coordinator of Multidisciplinary Team for Offender and Victim; and Circuit Judge and Counsel in Dependency Neglect or FINS Case of Offender
    		DOC12/14/2009
  • CFS-0291-N1
    Notice of Name Placement on Central Registry to School Where Victim Is Enrolled
    		DOC08/01/2009
  • CFS-0291-N2
    Notice of Name Placement on Central Registry to School Where Offender Is Enrolled
    		DOC08/01/2009
  • CFS-0292-N
    Notice of Name Placement on Central Registry to Offender
    		DOC04/11/2011
  • CFS-0293-N
    Notice of Name Placement on Central Registry to Mandated Reporter
    		DOC04/11/2011
  • CFS-0294-N
    Notice of Name Placement on Central Registry to Licensing or Registering Authority, Employer, or Entity in Charge of a Paid or Volunteer Activity
    		DOC04/11/2011
  • CFS-0295-N
    Notice of Name Placement on Central Registry to Child Safety Center Involved in Investigation of Maltreatment
    		DOC04/11/2011
  • CFS-0296-N
    Notice of Name Placement on Central Registry to Employer of Offender in a Designated Position with an Arkansas State Agency
    		DOC04/11/2011
  • CFS-0300 Spanish
    Notification of Changes in Out-of-Home Placement (Spanish)
    		DOC11/01/2005
  • CFS-0300
    Notification of Changes in Out-of-Home Placement
    		DOC11/01/2005
  • CFS-0300A
    Attorney-Ad-Litem, Court Appointed Special Advocate and Child Notification of Changes in Out-of-Home Placement
    		DOC11/01/2005
  • CFS-0304
    Justification for Special Board Rate Form
    		DOC04/11/2011
  • CFS-0313
    Office of Chief Counsel Review of Administrative Hearing Investigative Determination
    		DOC02/01/2008
  • CFS-0316
    REQUEST FOR CHILD MALTREATMENT CENTRAL REGISTRY CHECK
    		DOC08/24/2011
  • CFS-0317
    Off-Site Worker's Safety Log
    		DOC10/29/2009
  • CFS-0320
    Administrative Hearing Statement
    		DOC04/13/2010
  • CFS-0321
    Referral for Investigation
    		DOC06/01/2009
  • CFS-0322
    Homemaker Referral
    		DOC06/01/2009
  • CFS-0323 Spanish
    Protective Custody/Parental Notification (Spanish)
    		DOC06/01/2009
  • CFS-0323-A Spanish
    Notice to Adult Relatives by Blood or Adoption that a Child Has Been Taken into DCFS Custody (Spanish)
    		DOC11/01/2011
  • CFS-0323-B Spanish
    Notice to Fictive Kin or Adult Relatives that a Child Has Been Taken into DCFS Custody (Spanish)
    		DOC11/01/2011
  • CFS-0323
    Protective Custody/Parental Notification
    		DOC06/01/2009
  • CFS-0324
    Checklist of Homemaker’s Activities
    		DOC08/01/2009
  • CFS-0325
    Notification of Complaint Other Than Child Maltreatment
    		DOC08/01/2009
  • CFS-0326
    Outcome of Complaint Investigation (Other Than Child Maltreatment)
    		DOC08/01/2009
  • CFS-0327 Spanish
    Notification of Name Removal from the Central Registry (Spanish)
    		DOC06/01/2009
  • CFS-0327
    Notification of Name Removal from the Central Registry
    		DOC06/01/2009
  • CFS-0328A
    Request for Name Removal From the Central Registry
    		DOC08/01/2009
  • CFS-0328B
    Request for Name Removal from the Central Registry by Juvenile Offender
    		DOC08/15/2009
  • CFS-0329
    Child Death Notification
    		DOC08/01/2009
  • CFS-0332
    Income Assistance Request Log
    		DOC08/01/2009
  • CFS-0333
    Client Information Sheet for Cash Assistance and Foster Care Incidentals
    		DOC08/01/2009
  • CFS-0334
    Foster Care Services - Authorization For Billing
    		PDF08/01/2010
  • CFS-0336 Spanish
    Expiration of Protective Custody/Parental Notification (Spanish)
    		DOC05/01/1997
  • CFS-0336
    Expiration of Protective Custody/Parental Notification
    		DOC05/01/1997
  • CFS-0341
    Certification of Absence of Criminal Record
    		DOC01/01/2011
  • CFS-0345
    Intensive Family Services Referral
    		DOC09/21/2010
  • CFS-0347
    Intensive Family Services Family Counselor’s Time Record
    		DOC08/01/2009
  • CFS-0351
    Initial Dental Examination
    		DOC08/01/2009
  • CFS-0352
    Medical, Dental, Vision, Hearing & Psychological Episodic Form
    		DOC06/10/2010
  • CFS-0353
    Requested Medical Records Log
    		DOC08/01/2009
  • CFS-0360
    Request for Conference/Training
    		DOC07/01/1995
  • CFS-0362
    Medi-Alert to Foster Care Provider
    		DOC04/09/2007
  • CFS-0363 Spanish
    Foster Parent, Adoptive Parent or Applicant Smoking Certification (Spanish)
    		DOC02/01/2008
  • CFS-0363
    Foster Parent, Adoptive Parent or Applicant Smoking Certification
    		DOC02/01/2008
  • CFS-0367
    Specialized Placement Referral Form
    		DOC11/01/2010
  • CFS-0368
    Child’s Health Services Plan
    		DOC08/01/2009
  • CFS-0376
    Authorization for Billing & Trust Account Action
    		DOC01/01/2011
  • CFS-0377
    Facility Trust Account Report
    		DOC11/02/2009
  • CFS-0379
    Close Out/Overpayment Notification
    		DOC11/02/2009
  • CFS-0380
    Trust Account Invoice
    		DOC11/02/2009
  • CFS-0381
    Training Record Log
    		DOC10/01/1993
  • CFS-0384
    Notification to Local Education Agency of Changes in Child Placement, Changes in Schools or Experiences of Traumatic Events
    		DOC08/01/2009
  • CFS-0388 Spanish
    Application & Agreement to Participate in DCFS Foster Care Driver's License Program (Spanish)
    		DOC12/04/2009
  • CFS-0388
    Application & Agreement to Participate in DCFS Foster Care Driver's License Program
    		DOC12/04/2009
  • CFS-0389 Spanish
    Application & Agreement to Participate in DCFS Foster Care Driving Insurance Reimbursement Program (Spanish)
    		DOC12/04/2009
  • CFS-0389
    Application & Agreement to Participate in DCFS Foster Care Driving Insurance Reimbursement Program
    		DOC01/13/2010
  • CFS-0405
    Foster Care/Adoption Services (Family Assessment Information)
    		DOC03/01/2008
  • CFS-0408
    Federal Parent Locator System Information
    		DOC08/01/2009
  • CFS-0409
    Foster/Adoptive Family Preference Checklist
    		DOC12/01/2009
  • CFS-0427
    Determination of Eligibility for Adoption Subsidy
    		DOC09/19/2011
  • CFS-0428-C
    Adoption Assistance Agreement For Non-Recurring Adoption Expense Payment
    		DOC11/02/2009
  • CFS-0429
    Special Adoption Subsidy Determination
    		DOC11/01/2007
  • CFS-4330
    Child Welfare Student Stipend Agreement
    		DOC04/13/2010
  • CFS-4331
    Educational Leave Contract - (Full-time/Part-time MSW Student)
    		DOC11/02/2009
  • CFS-4332
    Child Welfare Student Stipend Application
    		DOC10/01/2001
  • CFS-0434
    Mutual Consent Voluntary Adoption Registry
    		DOC11/02/2009
  • CFS-0445
    Foster Home Needs Assessment
    		DOC01/01/2005
  • CFS-0451
    Foster Parent Re-Evaluation
    		DOC02/01/2005
  • CFS-0455
    Request / Consent for Health Department Services
    		DOC03/01/2008
  • CFS-0456
    Birth Family Background Information
    		DOC08/01/2009
  • CFS-0457
    Hospital Data
    		DOC02/01/2005
  • CFS-0462-A
    Foster Home Agreement Addendum
    		DOC08/01/2009
  • CFS-0462
    Initial Foster Home Agreement
    		DOC08/01/2009
  • CFS-0465 Spanish
    Foster Parent Orientation Checklist (Spanish)
    		DOC11/02/2004
  • CFS-0467
    Adoption Recruitment Agreement
    		DOC08/01/2009
  • CFS-0470
    Selection of Adoptive Family
    		DOC09/01/2003
  • CFS-0471
    Disclosure for Adoption
    		DOC08/01/2009
  • CFS-0474
    Provisional Foster Home Orientation Checklist
    		DOC11/02/2009
  • CFS-0475B
    Quarterly Monitoring Checklist for Foster Home
    		DOC08/24/2011
  • CFS-0475F
    True Reports of Child Maltreatment Against Foster Family Members
    		DOC08/24/2011
  • CFS-0483
    Foster Home Re-evaluation Letter
    		DOC08/01/2004
  • CFS-0488
    Title IV-E Eligibility Summary
    		DOC10/01/2010
  • CFS-0489
    Foster Parent Request for Consideration to Adopt
    		DOC08/01/2009
  • CFS-0590 Spanish
    Invitation to Family-Centered Meeting (Spanish)
    		DOC08/01/2009
  • CFS-0597
    Request to Open a Medicaid Account on an ICPC Case
    		PDF11/13/2009
  • CFS-6010 Addendum - A
    Visitation Plan for New Case Plan
    		DOC08/01/2006
  • CFS-6010 Addendum - B
    Independent Living Skills
    		DOC11/02/2009
  • CFS-6013
    Application for Emergency Services
    		DOC07/01/2006
  • CFS-6024
    Permanency Planning Court Report
    		DOC08/01/2009
  • CFS-6091
    ICPC Parent / Relative Home Study Check List
    		DOC08/01/2009
  • CFS-6092-C
    ICPC Cover Letter
    		DOC08/18/2010
  • CFS-6092-S
    ICPC Social Summary
    		DOC04/07/2010
  • CFS-6092
    ICPC Home Study Request Check List
    		DOC04/07/2010
  • CFS-6093
    ICPC Foster Care Home Study Check List
    		DOC08/01/2009
  • CFS-6094
    ICPC Adoptive Home Study Check List
    		DOC08/01/2009
  • Child Care Referral Template
    Child Care Referral (Protective Services/Foster Care/Supportive Services)
    		PDF05/21/2008
  • CHRIS Data Problem Form
    CHRIS Data Problem Form
    		DOC04/11/2011
  • DHS-0081
    Consent for Release of Information
    		DOC05/01/1994
  • DHS-0359
    DHS Systems Security Access Request
    		DOC08/25/2009
  • DHS-4000
    Authorization to Disclose Health Information
    		DOC11/01/2005
  • Drug Screen-Alcohol Test Authorization
    Drug Screen & Alcohol Test Authorization Form
    		DOC08/01/2009
  • Foster Parent ITNA Tally Sheet
    The Learning Needs Assessment Tally Sheet
    		PDF04/11/2011
  • Foster Parent ITNA
    The Learning Needs Assessment Tool
    		PDF01/03/2011
  • ICPC-0100A
    Interstate Compact Placement Request
    		DOC08/01/2009
  • ICPC-0100B
    Interstate Compact Report on Child’s Placement Status
    		DOC08/01/2009
  • ICPC-0101
    ICPC Sending State Priority Home Study Request
    		DOC08/01/2009
  • ICPC-0030
    ICPC Supervision Report-30 day
    		DOC07/07/2010
  • ICPC-0090
    ICPC Supervision Report-90 Day
    		DOC07/07/2010
  • Missing Receipt for P-Card
    Missing Receipt for P-Card Transaction Form
    		PDF02/15/2011
  • NYTD Survey
    NYTD Survey
    		PDF10/01/2010
  • OCC-0410 Spanish
    Consent to Termination of Parental Rights (Spanish)
    		DOC03/01/2009
  • OCC-0410
    Consent to Termination of Parental Rights
    		DOC03/01/2009
  • Request for OST CHRIS Report
    Request for OST CHRIS Report
    		DOC08/01/2009
  • Request for Service / Encumbrance (Non-Placement Services Only)
    Request for Service / Encumbrance (Non-Placement Services Only)
    		XLS08/01/2009
  • SS-5-FS
    Application for a Social Security Card
    		PDF04/11/2011
  • VR-7
    Birth Certificate Application
    		PDF01/01/2009
  • VSP-1
    Authorization to Operate State Vehicles and Private Vehicles on State Business
    		DOC09/28/2010
  • VSP-2
    Authorization to Obtain Traffic Violation Record
    		DOC09/28/2010
  • VSP
    Arkansas State Vehicle Safety Program
    		PDF07/01/2010
  • CFS-0386
    Used when the CHRIS system is down for basic case information.
    		DOC04/11/2011
  • DOC04/11/2011
  • Prospective Foster/Adoptive Parent Inquiry Letter
    Prospective Foster/Adoptive Parent Inquiry Letter
    		DOC03/31/2011
  • PDF11/18/2010
  • PDF04/07/2011
  • PDF04/07/2011
  • CFS-0213-A
    School District Prohibition from Notifying a Parent, Guardian, or Custodian of a Child Maltreatment Investigation
    		DOC09/19/2011
  • PDF09/19/2011
  • PDF10/10/2011
  • CFS-0490
    Title IV-E Medicaid Eligibility Redetermination Summary
    		PDF02/18/2010
  • CFS-0323-A
    A Notice to Adult Relatives by Blood, Adoption or Marriage that a child has been taken into DCFS custody.
    		DOC11/01/2011
  • CFS-0343
    Notification of Court Appearance
    		DOC11/01/2011
  • CFS-0435-A
    A Subsidized Guardianship Application and Checklist
    		DOC11/01/2011
  • CFS-0435-C
    Subsidized Guardianship Special Subsidy Request
    		DOC11/01/2011
  • CFS-0323-B
    Notice to Fictive Kin that a child has been taken into DCFS custody
    		DOC11/01/2011
  • CFS-0486
    SSI Screening Questionnaire
    		DOC11/01/2011
  • CFS-0493
    Title IV E Medicaid Redetermination
    		DOC11/01/2011
  • CFS-0213-A Spanish
    School District Prohibition from Notifying a Parent, Guardian, or Custodian of a Child Maltreatment Investigation
    		PDF09/19/2011
  • CFS-0240-U1
    Unsubstantiated Child Maltreatment Investigative Determination to Alleged Underaged Juvenile Offender (under 13 years old)
    		DOC02/20/2012
  • CFS-0240-U2
    Unsubstantiated Child Maltreatment Investigative Determination to Alleged Juvenile Offender 13-17 Years of Age
    		DOC02/20/2012
  • CFS-0222-T
    Child Maltreatment True Investigative Notice to Facility Director
    		DOC02/20/2012
  • CFS-0224-T3
    Child Maltreatment True Investigative Determination Notice to Legal Parents and Guardians of Alleged Juvenile Offender 16-17 Years of Age
    		DOC02/20/2012
  • CFS-0224-T4
    Child Maltreatment True Investigative Determination Notice to Current Foster Parents of the Alleged Offender in Foster Care
    		DOC02/20/2012
  • CFS-0340
    PERMANENCY ROUNDTABLE REFERRAL FORM
    		DOC02/20/2012
  • CFS-0428-A
    Adoption Assistance Agreement for State Funded Subsidy Payments
    		DOC02/20/2012
  • CFS-0428-B
    Adoption Assistance Agreement for Federal IV-E Funded Assistance
    		DOC02/20/2012
  • PDF02/21/2012
  • CFS-0223-T2_Spanish
    Child Maltreatment True Inverstigative Determination Notice to Alleged Juvenile Offender 13-15 Years of Age
    		DOC02/20/2012
  • CFS-0224-T1_Spanish
    Child Maltreatment True Investigative Determination Notice to Legal Parents and Guardians of Underaged Juvenile Offender (under 13 years old)
    		DOC02/20/2012
  • CFS-0224-T3_Spanish
    Child Maltreatment True Investigative Determination Notice to Legal Parents and Guardians of Alleged Juvenile Offender 16-17 Years of Age
    		DOC02/20/2012
  • CFS-0224-T4_Spanish
    Child Maltreatment True Investigative Determination Notice to Current Foster Parents of the Alleged Offender in Foster Care
    		DOC02/20/2012
  • CFS-0240-U1_Spanish
    Unsubstantiated Child Maltreatment Investigative Determination to Alleged Underaged Juvenile Offender (under 13 years old)
    		DOC02/20/2012
  • CFS-0240-U2_Spanish
    Unsubstantiated Child Maltreatment Investigative Determination to Alleged Juvenile Offender 13-17 Years of Age
    		DOC02/20/2012
  • CFS-0435-D
    Recommendation for Finalization of Guardianship
    		DOC04/16/2012
  • CFS-0252-U
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Alleged Offender (Spanish)
    		DOC10/01/2010
  • CFS-0225-T1 Spanish
    Child Maltreatment True Investigative Determination Notice to Victim, Legal Parent(s), and Legal Guardian(s) of the Alleged Victim (Spanish)
    		DOC10/01/2010
  • CFS-0225-T2 Spanish
    Child Maltreatment True Investigative Determination Notice to Current Foster Parents of Alleged Victim in Foster Care (Spanish)
    		DOC10/01/2010
  • CFS-0245-U Spanish
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Legal Parent(s), Legal Guardians, and Current Foster Parents of the Alleged Victim (Spanish)
    		DOC10/01/2010
  • CFS-0245-U1 Spanish
    Notice of Unsubstantiated Child Maltreatment Investigative Determination to Alleged Victim (Spanish)
    		DOC10/01/2010
  • CFS-0264-O Spanish
    Notice of Overturned True Child Maltreatment Investigative Determination to Legal Parent(s) and Legal Guardian(s) of the Alleged Offender (Spanish)
    		DOC10/01/2010
  • CFS-0265-O1 Spanish
    Notice of Overturned True Child Maltreatment Investigative Determination to Victim and Legal Parent(s) and Legal Guardian(s) of Alleged Victim (Spanish)
    		DOC10/01/2010
  • CFS-0272-O Spanish
    Notice of Overturned True Child Maltreatment Investigative Determination to Alleged Offender (Spanish)
    		DOC10/01/2010
  • CFS-0285-N Spanish
    Notice of Name Placement on Central Registry to Victim, Legal Parent(s), Legal Guardian(s), and Current Foster Parent(s) of Victim (Spanish)
    		DOC10/01/2010
  • CFS-0292-N Spanish
    Notice of Name Placement on Central Registry to Offender (Spanish)
    		DOC10/01/2010
  • CFS-0293-N
    Notice of Name Placement on Central Registry to Mandated Reporter (Spanish)
    		DOC10/01/2010
  • CFS-0343 Spanish
    Notification of Court Appearance (Spanish)
    		DOC11/01/2011
  • CFS-0225-T2
    Child Maltreatment True Investigative Determination Notice to Current Foster Parents of Alleged Victim in Foster Care
    		DOC10/01/2010
  • CFS-0025
    Transitional Youth Services Budget
    		XLS07/26/2012
  • CFS-0475A
    Initial Checklist for Foster/Adoptive Home Assessment
    		DOC08/27/2012
  • CFS-0327-A
    Physical Documentation - Body Diagram
    		DOC08/27/2012
  • CFS-0475C
    Reevaluation Checklist for Foster/Pre-Adoptive Home
    		DOC08/27/2012
  • CFS-0370
    Residence Checklist for Youth
    		DOC06/01/2011
  • DOC
  • CFS-0435-E
    Consent to Guardianship
    		DOC09/01/2012
  • CFS-0100
    Authorization for Release of Information for Differential Response
    		PDF10/01/2012
  • CFS-0435-F
    Guardianship Assistance Agreement
    		DOC01/01/2013
  • CFS-0435-H
    Notice of Modification or Termination of Subsidized Guardianship Agreement
    		DOC01/01/2013
  • CFS-0099
    FASD Screening Referral Form
    		PDF01/01/2013
  • CFS-0101
    FASD Plan of Safe Care
    		PDF01/01/2013
  • CFS-0232-T2
    True But Exempt Child Maltreatment Investigative Determination Notice to Offender
    		DOC01/14/2013
  • PDF
  • CFS-0223-T1_Spanish
    Child Maltreatment True Investigative Determination Notice to Underaged Juvenile Offender (under 13 years old)_Spanish
    		DOC02/20/2012
  • CFS-0223-T3_Spanish
    Child Maltreatment True Investigative Determination Notice to Alleged Juvenile Offender 16-17 Years of Age
    		DOC02/20/2012
  • CFS-0223-T4
    Child Maltreatment True Investigative Determination Notice to Alleged Juvenile Offender (if currently age 18 or older)
    		DOC02/21/2012
  • CFS-0223-T4_Spanish
    Child Maltreatment True Investigative Determination Notice to Alleged Juvenile Offender (if currently age 18 or older)
    		DOC02/21/2012
  • CFS-0224-T1
    Child Maltreatment True Investigative Determination Notice to Legal Parents and Guardians of Underaged Juvenile Offender (under 13 years old)
    		DOC02/20/2012
  • CFS-0224-T2
    Child Maltreatment True Investigative Determination Notice to Legal Parents and Guardians of Alleged Juvenile Offender 13-15 Years of Age
    		DOC02/20/2012
  • CFS-0224-T2_Spanish
    Child Maltreatment True Investigative Determination Notice to Legal Parents and Guardians of Alleged Juvenile Offender 13-15 Years of Age
    		DOC02/20/2012
  • CFS-0426
    Statement of Income and Resources for Adoption Subsidy
    		PDF08/01/2009
  • CFS-0432
    Recommendation for Finalization of an Adoption
    		PDF04/01/2013
  • CFS-0420
    Legal Risk Adoption Placement Agreement
    		PDF08/01/2009
  • CFS-0491
    Consent for Use of Funds and Resources
    		PDF11/02/2009
  • CFS-0411
    Affidavit
    		PDF11/02/2009
  • CFS-0414
    Adoption Services Change of Status
    		PDF10/01/2005
  • CFS-0418
    Notice of Custody w/Power to Consent to Adoption Procedure
    		PDF08/01/2009
  • CFS-0423
    Certificate of Service
    		PDF09/01/2008
  • CFS-0494
    Notification of Adoption for Medicaid
    		PDF11/06/2009
  • CFS-0496
    Assessment for Income Assistance
    		PDF08/01/2009
  • CFS-0404
    General Medical Report
    		PDF02/06/2013
  • CFS-0465
    Foster Parent Orientation Checklist
    		PDF02/08/2013
  • CFS-0487
    Application for Title IV-E Payments/Medicaid
    		PDF02/08/2013
  • CFS-0433
    Individualized Adoption Recruitment Plan
    		PDF09/01/2003
  • CFS-0330
    Protective Services Alert Notification
    		DOC07/01/2004
  • CFS-0446
    In Home Consultation Visit Report
    		PDF06/01/2011
  • CFS-0450
    Provisional Foster Home Referral
    		PDF02/25/2013
  • CFS-0452
    Provisional Foster Home Verification
    		PDF08/01/2009
  • CFS-0419
    Foster Family Support System (FFSS) Information
    		PDF01/01/2011
  • CFS-0004
    Request for After Care Support
    		PDF01/01/2011
  • CFS-0397
    Educational Assessment
    		PDF05/01/1994
  • CFS-0475D
    Transfer of Foster Home from Another County
    		PDF08/22/2011
  • CFS-0475G
    Checklist for Foster Home Closure
    		PDF08/22/2011
  • CFS-0594
    Meal Voucher Authorization for "FEED THE KIDS" Program
    		PDF02/23/2010
  • CFS-0593
    DCFS Arkansas State Vehicle Safety Program
    		PDF09/01/2007
  • CFS-0495
    Notification of Change
    		PDF10/20/2009
  • CFS-0480
    Alternate Compliance of Water Supply Agreement
    		PDF02/01/2005
  • CFS-0476
    DCFS Training Completion Certificate
    		PDF01/01/2008
  • CFS-0482
    Foster Home Approval Letter
    		PDF08/01/2004
  • CFS-0201A
    Notice of Child Maltreatment Allegation to Law Enforcement and Prosecuting Attorney
    		PDF10/01/2010
  • CFS-0209-A
    Notice of Child Maltreatment Allegation to AAL or CASA of Child in Foster Home Where Maltreatment Is Reported or Where an Alleged Juvenile Offender or Underaged Juvenile Offender is Placed
    		PDF10/01/2010
  • CFS-0208-A
    Notice of Child Maltreatment Allegation to Attorney Ad Litem and CASA of Alleged Offender
    		PDF10/01/2010
  • CFS-0206-A
    Notice of Child Maltreatment Allegation to Attorney Ad Litem, CASA, and Counsel in Dependency Neglect or FINS Case of Alleged Victim(s)
    		PDF10/01/2010
  • CFS-0205-A
    Notice of Child Maltreatment Allegation to Legal Parent(s), Legal Guardian(s), and Current Foster Parent(s) of Alleged Victim(s) in Foster Care
    		PDF10/01/2010
  • CFS-0205-A Spanish
    Notice of Child Maltreatment Allegation to Legal Parent(s), Legal Guardian(s), and Current Foster Parent(s) of Alleged Victim(s) in Foster Care (Spanish)
    		PDF10/01/2010
  • CFS-0204A
    Notice of Child Maltreatment Allegation to Legal Parent(s), Legal Guardian(s) and Current Foster Parent(s) of Alleged Offender in Foster Care
    		PDF10/01/2010
  • CFS-0204A Spanish
    Notice of Child Maltreatment Allegation to Legal Parent(s), Legal Guardian(s) and Current Foster Parent(s) of Alleged Offender in Foster Care (Spanish)
    		PDF10/01/2010
  • CFS-0202-A
    Notice of Child Maltreatment Allegation to Licensing/Registering Authority
    		PDF09/19/2011
  • CFS-0223-T2
    Child Maltreatment True Inverstigative Determination Notice to Alleged Juvenile Offender 13-15 Years of Age
    		PDF02/20/2012
  • CFS-0223-T1
    Child Maltreatment True Investigative Determination Notice to Underaged Juvenile Offender (under 13 years old)
    		PDF02/20/2012
  • CFS-0331
    Documentation of Child’s Medical Episode Related to Near Fatality/Fatality
    		PDF03/27/2013
  • CFS-0223-T3
    Child Maltreatment True Investigative Determination Notice to Alleged Juvenile Offender 16- 17 Years of Age
    		PDF02/20/2012
  • CFS-0435-B
    Notification of Subsidized Guardianship Program Denial
    		PDF04/01/2013
  • CFS-0484
    Landlord Notification of Potential Tenant Foster Care Services
    		PDF08/27/2012
  • CFS-0509-A
    Recommendation To The Child Welfare Agency Review Board
    		PDF08/01/2006
  • CFS-0509-B
    Request For Alternative Compliance or Policy Waiver
    		PDF04/01/2008
  • CFS-0475E
    Complaint Against Foster Family Other Than Child Maltreatment
    		PDF08/22/2011
  • CFS-0595
    Meal Authorization Log for "FEED THE KIDS" Program
    		PDF11/02/2009
  • CFS-0592
    Financial/Medical Plan Interstate Compact on the Placement of Children
    		PDF08/01/2009
  • CFS-0590
    Invitation to Family-Centered Meeting
    		PDF08/01/2009
  • CFS-0002
    Life Plan & Agreement for Youth in Transition
    		PDF01/01/2001
  • CFS-0210A
    Notice of Child Maltreatment Allegation to DHS Division Director; Coordinator of Multidisciplinary Team for Alleged Victim or Offender; and Counsel in Dependency Neglect or FINS Case for Alleged Offender
    		PDF09/09/2011
  • CFS-0425
    Application for Adoption Subsidy
    		PDF04/22/2013
  • CFS-0492
    ICAMA Medicaid Eligibility
    		PDF06/01/2011
  • CFS-0431
    Certification of Adoption Subsidy Eligibility
    		PDF04/01/2013
  • CFS-0435G
    Annual Subsidized Guardianship Review
    		PDF01/01/2013
  • CFS-0342
    State Police Criminal Record Check
    		PDF08/22/2011