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2026 Foster Care Screening Questionnaire
bryan.culbert@familypartnerships.org
2026-02-03T10:33:50-05:00
2026 Foster Care Screening Questionnaire
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Parent Name 1
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Miss
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Ms.
Mx.
Prof.
Rev.
Prefix
First
Middle
Last
Suffix
Date
MM slash DD slash YYYY
Email
Phone
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How Did You Hear About Us?
Are You Open To Accepting Sibling Groups?
Yes
No
Minimum Age Range
Maximum Age Range
Marital Status
Single
Married
Divorced
Other
Current Home Type
Single family
Apartment
Condo
Living with relatives
Number of Bedrooms
1
2
3
4
5
6
7
8
9
10
What is the number of additional adults living in the home?
(Required)
Number of youth under 18 living in the home?
(Required)
List ALL members of your household (anyone who lives in your home not already listed)
Name
First
Last
Relationship
Date of Birth
MM slash DD slash YYYY
Name
First
Last
Relationship
Date of Birth
MM slash DD slash YYYY
Name
First
Last
Relationship
Date of Birth
MM slash DD slash YYYY
Name
First
Last
Relationship
Date of Birth
MM slash DD slash YYYY
Name
First
Last
Relationship
Date of Birth
MM slash DD slash YYYY
Name
First
Last
Relationship
Date of Birth
MM slash DD slash YYYY
Do you have a vehicle that can hold your family and an extra child?
(Required)
Yes
No
Are you currently employed
(Required)
Yes
No
Do you all produce income to support your family and an additional child if placed in your home?
(Required)
Yes
No
Assistance from government such as Food Stamps, Section 8 housing or unemployment?
(Required)
Details
Does anyone in the house have any arrests or felonies?
(Required)
If yes, please explain
Have any of your household members lived out of the state of Florida in the past 5 years?
(Required)
Yes
No
If yes, Name of household members
(Required)
List previous states in the past 5 years
Are you each U.S. citizens? If not, what is your status?
(Required)
Yes
No
Additional details
How would you describe your household's overall motivation to foster?
Providing temporary care and stability
Supporting family reunification
Keeping siblings together
Helping teens or youth with higher needs
Adoption interest
Other
Additional details for "other" response
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