Placement Forms Resource
There are a lot of forms that are required relating to removal and placement of a child. Click on each section for placement forms pertinent to that situation.
Go to the Pre-Service Module on Court, Section 1, Court Protocol for Removing a Child, for a quick description of the correct forms for the specific reason for removal. The forms you will be using are listed and linked below.
- Temporary Physical Custody Request: JC-1608 , Form Summary
- Temporary Physical Custody Request Supplement: JC-1609 , Form Summary
- Dispositional Order - Protection or Services: JC-1611 , Form Summary
- Notice of Change in Placement: JC-1754 , Form Summary
- Temporary Physical Custody Hearing Preparation Guide - Chapter 48: Guide
- Temporary Physical Custody Request: JD-1710 , Form Summary
- Court Order: JD-1711 , Form Summary
- Change of Placement Notice: JD-1754 , Form Summary
- Request to Change Placement, Revise Disposition Order, Extend Disposition Order, Review Permanency Plan: JD-1766 , Form Summary
- Notice of Post-Post Disposition Emergency Change in Placement and Hearing Request (In-Home to Out-of-Home): JD-1767 , Form Summary
- Post-Disposition Emergency Change in Placement Order (In-Home to Out-of-Home): JD-1768 , Form Summary
- Order for Change in Placement (In-Home to Out-of-Home): JD-1789 , Form Summary
- Order for Change in Placement (Out-of-Home to Out-of-Home): JD-1790 , Form Summary
- Notice of Change in Placement - ICWA: IW-1754 , Form Summary
- Request to Change Placement, Revise Dispositional Order, Extend Dispositional Order, Review Permanency Plan – ICWA: IW-1766 , Form Summary
- Order for Change of Placement (In-Home to Out-of-Home) - ICWA: IW-1789 , Form Summary
- Order for Change of Placement (Out-of-Home to Out-of-Home) - ICWA: IW-1790 , Form Summary
When a child is placed in out-of-home care under chs. 48 or § 938, the agency having “placement and care responsibility” must ensure that all laws and policies related to children in out-of-home care are adhered to.
At the time of placement the caseworker is responsible to ensure that all necessary legal documents and notifications are made to the child, their parents, the out-of-home provider, relatives, and the legal community. (Ongoing Standards)
- Foster Home Agreement Child Placed in Out-of-Home Care by Agency
- Relative Caregiver Agreement Child Placed in Out-of-Home Care by Agency: English , Hmong , Spanish
Notify all adult relatives that the child or juvenile has been placed into out-of-home care. Anytime that a child or juvenile is removed from their parent(s)’ home under a court order and is not returned within 30 days, the notice must be sent.
Provide information to the physical custodian of the child (child’s out-of-home care provider) as required under §. 48.371, Stats. upon placement, but no later than 48 hours if unknown to the agency at the time of placement:
Obtain signed consents for:
- Medical Services Consent: English, Hmong, Spanish
- Relatives and other informal supports
- Other service providers the child may be utilizing including, but not limited to school, child care facility, therapists, physicians, private agencies involved, etc.
Obtain medical services coverage either through the health insurance of the child’s parent or Medicaid.
If a child is identified as an Indian child and WICWA applies, the agency is required to notify the child’s tribe within 24 hours the child’s name and address or expectant mother’s name and address.
- Notification is completed by sending the following forms to the child’s tribe:
Notify the clerk of the school district in which a foster home is located when a school-age child is placed in that foster home, as required under §. 48.64 (1r), Stats. The notification shall include all of the following:
- The name, address, and phone number of the foster parent.
- The name of the foster child.
- Information about the child required by the school, as allowed under any applicable confidentiality laws.
Ensure the child is properly enrolled in an educational setting as required by law.
Document the child’s placements into out-of-home Care into eWiSACWIS within five days.
The primary purpose of this manual is to clarify eWiSACWIS placement documentation requirements for child welfare staff, supervisors and managers. The manual is divided into four main components as follows:
- Core Principles to Placement Documentation
- Key Terms and Definitions for Placement Documentation
- Contact Information for Placement-Related Documentation
- “How Do I” Guides by Placement Setting (Appendix)
- Creating an Out-of-Home Placement
- Ending an Out-of-Home Placement
- Notification of Placement
There are several sites that have other forms related to out-of-home placement.