FYI  FYI  FYI  FYI

F O R   Y O U R   I N F O R M A T I O N

ISSUE  00-64

DATE:  10/00

REVISED/CANCELLED ADOPTIONS FORMS

The following forms have been revised:

  • The DCS 65D, Supervisorís Approval of Inter-Agency Placement, has been revised, renumbered and renamed as follows: DCFS/A 65D, Inter-Agency Placement Approval. See Attachment A.
  • The DCS/A 119, Transmittal to Attorney, has been revised, renumbered and renamed as follows: DCFS/A 119, Attorney Authorization Agreement.  See Attachment B.
  • The DCS/A 217, Reimbursement of Nonrecurring Expenses Agreement, has been revised, renumbered and renamed as follows: DCFS/A 217, Reimbursement Agreement for Nonrecurring Adoption Expenses.  See Attachment C.
  • The DCS/A 226, Inter-Agency Letter has been revised and renumbered as DCFS/A 226. See Attachment D.

The following forms are being cancelled:

  • The DCFS/A 171, Inter-Agency Placement Agreement, has been replaced by the AD 907, Adoptive Placement Agreement. Please recycle all DCFS/A 171 forms.
  • The DCFS/A 74, Consent for Medical, Surgical and Dental Care, has been replaced by the DCFS 4158, Authorization for General Medical Care for a Child Placed by an Order of the Juvenile Court. Please recycle all DCFS/A 74 forms.
 


CONTACT: Darlene Salazar (213) 351-5736

APPROVED:__________________________
                        
Beverly Muench, Deputy Director