Forms

This section contains forms for both the child foster care licensing / relicensing process and forms pertaining to children currently in care. For further information or assistance, please contact the licensing unit at 651-213-5600.

Foster Care Licensing & Relicensing Forms

• Chemical Usage Policy (PDF): This policy should be completed by the license holder, signed by license holder and all backup providers, copy sent to licensing worker, and original kept in license holders' file.
• Foster Parent Agreement (PDF): This agreement between foster parents and the licensing agency outlines their respective responsibilities.
• Home Safety Checklist (PDF): To verify safety of the home, used at initial and relicensing. This form must be completed by all Child Foster Care applicants/license-holders.
• Individual Fact Sheet (PDF): You must write your health issues or state you are in good health. You must also complete the section regarding chemical health (stating you have been free of any chemical use problems for the past 2 years).
• MN Adoption and Child Foster Care Application (PDF)
• Substitute Care (PDF): Written substitute care planning form.

Foster Care Forms for Children in Care

• Authorization to Take Child Out of State (PDF): Needed for all trips out of Minnesota.
• Contact Information Sheet (PDF): General information about foster child.
• Health Record (PDF): To keep track of foster child's illnesses and therapy, doctor, and dental appointments.
• Incident Report Form (PDF): To document any accidents or injuries of foster children, criminal behavior, running away, destruction of property, etc.
• Personal Inventory Form (PDF): Assist in tracking child's belongings and other personal items.
• Respite Caregiver (PDF): Information about foster child to be given to respite care provider.
• Visitation / Contact Log (PDF): To document parent / guardian contacts with child.