Forms

Please tell us if you need assistance because you do not speak English or have a disability. Free language assistance and/or other aids and services are available upon request. To receive free interpreter services, call 866-719-0141 or ask at the DSS local office. After the recorded message, you will reach an operator who can provide you with an interpreter. If you have a disability and need communication assistance, call 866-719-0141 or TTY: 711.
Title Effective Date
DSS-5157: Foster Home Relicense, Termination and Change Request Application May 20, 2019 12:40 PM
DSS-5158: Foster Home Transfer Request Application Jun 03, 2016 12:40 PM
DSS-5159: Foster Home Change Request Application May 20, 2019 12:40 PM
DSS-5160: Foster Home Termination Application Oct 14, 2021 03:25 PM
DSS-5162: Petition for Adoption of a Minor Child (Step-parent) Jun 03, 2016 02:05 PM
DSS-5163: Petition for Adult Adoption Jun 03, 2016 02:05 PM
DSS-5164: Consent to Adoption by Adult Adoptee Jun 03, 2016 02:10 PM
DSS-5165: Consent to Adult Adoption by Spouse of Petitioner Mar 15, 2017 02:20 PM
DSS-5166: Decree of Adult Adoption Mar 15, 2017 02:20 PM
DSS-5167: Report to Vital Records for Adult Adoption Dec 10, 2019 11:40 AM
DSS-5168: Revocation of Child's Consent to Adoption Jun 03, 2016 02:25 PM
DSS-5169: Consent of Child for Adoption (Step-parent Adoption) Jun 03, 2016 02:25 PM
DSS-5170: Report to Vital Records (Stepparent Adoption) Dec 10, 2019 11:40 AM
DSS-5189: Consent to Adoption by Parent Who is Spouse of Stepparent Jun 03, 2016 02:30 PM
DSS-5189I: Notice to Parent of Proposed Change in Placement of Child(ren) Sep 27, 2019 10:35 AM
DSS-5189II: Notice to Parent Regarding Proposed Change in the Placement of Child(ren) Nov 25, 2019 10:00 AM
DSS-5189III: Notice to Permanency Planning Review Sep 27, 2019 10:35 AM
DSS-5189IV: Notice to Parent Regarding Permanency Planning Review Outcome Nov 25, 2019 10:00 AM
DSS-5190: Consent to Adoption by Parent Who Is Not the Stepparent's Spouse Jun 03, 2016 02:45 PM
DSS-5191: Affidavit - Disclosure of Fees & Expenses Jun 03, 2016 02:45 PM
DSS-5199: Foster Home Request for Waiver Jun 03, 2016 02:50 PM
DSS-5201: Understanding Foster Care - A Handbook for Parents Jun 03, 2016 02:50 PM
DSS-5203: Initial Provider Assessment Dec 05, 2019 12:10 PM
DSS-5203ins: Initial Provider Assessment Instructions Dec 04, 2019 04:25 PM
DSS-5204: Comprehensive Provider Assessment Sep 26, 2019 10:55 AM
DSS-5204ins: Instructions for Comprehensive Provider Assessment Sep 26, 2019 11:00 AM
DSS-5206: Health Summary Form - Initial Visit Jun 03, 2016 02:55 PM
DSS-5207: Health History Form Jun 03, 2016 03:00 PM
DSS-5207ins: Health History Form Instructions Jun 03, 2016 03:00 PM
DSS-5208: Health Summary Form - 30-day Comprehensive Visit Jun 03, 2016 03:00 PM