Date |
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Parent’s Name(s) |
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Address |
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Phone Number(s) |
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Purpose of Home Study |
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Composition of Family |
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Desired characteristics of child |
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Families strengths and attributes |
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Have you ever had a Home Study? |
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If so, what were the results? |
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Are your circumstances different today? |
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Does anyone in your home have a criminal history? |
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If so, please explain |
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Has anyone in your home been investigated by Child Protective Services? |
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If so, what was the outcome? |
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When is the best time for you to talk on the phone? |
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When is the best time for you to meet? |
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