ࡱ> ~i'` 0bjbj{P{P *2::UJ8^^^^^^^5hXJ(rrrMM|@-4P~~~~~~$h>~^-MM-->~^^rr~   -X^r^r- --  l0^^rj $`X$05HH^ hqJ <6   >~>~   5----doVjV^^^^^^ TREATMENT FOSTER CAREDHS FC Worker Load #: FORMTEXT      PERMANENT WARD SERVICE PLANDHS FC Worker Name: FORMTEXT      Michigan Department of Human ServicesPOS Agency Name: FORMTEXT      POS Agency Worker Name: FORMTEXT      County of Referral: FORMTEXT      Court Jurisdiction: FORMTEXT      Court Docket #: FORMTEXT      Report Period:  FORMTEXT      to FORMTEXT       (maximum three months) Report Date:  FORMTEXT       The date the report is completedIDENTIFYING INFORMATIONChild(ren): (List separately) name, date of birth, case number, date entered care, current placement type (if relative care, name and address of relative; if institution, name and address of institution; if foster home, note foster home placement only), date entered current placement, and permanency planning goal. Specify if the child(ren) is Native American and tribal affiliation, if applicable.NameDate of BirthLog NumberCase NumberChild GenderChild RaceHeightWeightHair Color FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Eye ColorReligionDated Entered CareDate of Current PlacementCurrent Placement TypeAnticipated Next Placement FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN Date of Anticipated Next PlacementCurrent Legal StatusFederal Permanency Plan Goal FORMTEXT       FORMTEXT       FORMDROPDOWN Child s Address (if not FH) FORMTEXT      Native American? FORMDROPDOWN If Yes, Tribal Affiliation FORMTEXT      I.LEGAL STATUS A.Court History Child(ren): (list separately) name, petition date, petition type, hearing date, hearing outcome, order date, order type, requirements of the court through its order.  MACROBUTTON [2] "Click Here and Type"  B.Next Court Date:  MACROBUTTON [2] "Click Here and Type"  II.REASONABLE EFFORTSNote:For children who may be Native American, see Services Manual Item 742, Active and Reasonable Efforts A.Efforts made by the Agency to place the child in a permanent placement in a timely manner. Indicate expected duration of treatment, treatment recommendations that are likely to facilitate a successful discharge.   MACROBUTTON [b2] "Click Here and Type"  B.If services were not provided, explain the reasons why services were not provided.   MACROBUTTON [b2] "Click Here and Type"  III.SOCIAL WORK CONTACTS List date, person(s) contacted, role/position and type of contact (telephone, in person, home visit, office visit, etc.) for each contact, attempted contact and scheduled, but unkept appointments. Provide a brief narrative statement of the specific reason for the contact. Limit the narrative to one sentence. If HU or FF contact made, indicate where contact took place.  Team Meetings:  MACROBUTTON [1] Click Here and Type  Supervision:  MACROBUTTON [1] Click Here and Type  Face-to-face and Home Visits:  MACROBUTTON [1] Click Here and Type  Other Social Work Contacts:  MACROBUTTON [1] Click Here and Type  IV.PROGRESS SUMMARY A.Child Reassessment 1.a. Child Needs and Strengths and Current Status: Indicate, for each permanent ward; Address and explain each individual item scored as a strength or need on the Child Assessment of Needs and Strengths. Identify and describe the priority needs of the child for service. Identify the situational concerns, which cannot be identified in consecutive report periods. List and describe all other strengths of the child whether identified on the assessment or not. Discuss outcomes of updated CAFAS/PECFAS. Identify short term goals and progress on identified goals. Identify services to meet childs goals.   MACROBUTTON [b1] "Click Here and Type"  b. Mental Health Treatment: List contacts with therapist. Summarize progress on treatment goals. Identify changes made to treatment goals and why.   MACROBUTTON [b2] "Click Here and Type"  2.Placement Information The current placement and any replacements during the reporting period. any change in the placement household during the review period. Include results of Central Registry and criminal record checks and assessment of investigation if applicable, if new adults are in the placement household. Child nameLiving ArrangementBegin DateEnd Date FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       Reason for Replacement: Indicate activities to prepare child for move.  MACROBUTTON [b2] "Click Here and Type"  3. a.Child(ren) s Current Status Indicate for each child under court jurisdiction: Describe current status of child including: Significant events since the last assessment; Distinctive characteristics. Emotional and physical development. Hobbies, likes and dislikes, etc., Relationships with siblings, if applicable, Behavioral and past experiences, Describe interventions utilized by TFC parent to support the child.   MACROBUTTON [2] "Click Here and Type"  3. b.Behavior Aide Activities: Describe activities/interventions utilized to support the child/planning family.   MACROBUTTON [2] "Click Here and Type"  4.Education Information Educational including the current school, grade, and pass or fail. Outline strategies utilized to support child in his/her educational setting. Summarize school personnels report of childs progress.   MACROBUTTON [2] "Click Here and Type"  5.Medical and Dental Information Medical, dental and optical appointments and outcomes during report period. List names of medications prescribed dosages and frequency Provide name of prescribing Doctor and follow up appointments scheduled Note when medical consents were signed and by whom. Note any concerns with side effects, etc.   MACROBUTTON [2] "Click Here and Type"  6.Placement Resources a.Sibling Placement If child(ren) has siblings who are not placed in the same placement, provide an explanation of the reasons for the split placement. Note: If sibling placement is split, second line supervisor approval is required. The Second Line Supervisor must sign the PWSP in the space designated at the end of the PWSP. Specify visitation plan to maintain sibling connections. Note frequency and duration of visits. If there are no siblings or if siblings are placed together, write N/A.   MACROBUTTON [b2] "Click Here and Type"  bSibling and Relative Visitation Provide a report on all visits between siblings, if in separate placements, or any relative visits. Include all visits with adult siblings, siblings not in care and potential placements in the relative network. Include observations on the quality of the visits. Include a discussion of any exceptions (missed appointments, changed appointments, suspensions of appointments and changes in supervision status) to the plan during the reporting period. If there are no siblings or planned relative visits, write N/A in the space below.  MACROBUTTON [b2] "Click Here and Type"  c.Planning Family: Describe interventions utilized to prepare the family for childs discharge and progress towards discharge. Specify the visitation plan with the planning family to prepare the child and family for discharge. Discuss family progress towards discharge. If a planning family has not been identified, specify efforts made to identify a planning family.   MACROBUTTON [b2] "Click Here and Type"  d.Best Interests of Current Placement Describe the foster parent / relative caregivers willingness and capacity to meet the specified needs of the child and, Why this current placement is in the childs best interest.   MACROBUTTON [b2] "Click Here and Type"  7.Residential Care If the youth is 10 years of age or over and is placed in a residential or institutional setting: Document whether Wraparound or Assisted Care efforts were made to prevent the residential placement. Identify the plan for services that will allow the youth to be placed in a less restrictive setting. OR If the youth is under age 10 and is placed in a residential or institutional setting. Document whether Wraparound or Assisted Care efforts were made to prevent the residential placement. Document that a screening for Fetal Alcohol Spectrum Disorder was completed. Identify the plan for services that will allow the youth to be placed in a less restrictive setting. If there were no services provided, explain why not. If the youth is not placed in a residential or institutional setting, write N/A in the space provided.   MACROBUTTON [b2] "Click Here and Type"  8.Permanent Wardship For each child list the permanency planning and Michigan.a.Describe the effort made to finalize the permanency plan.  MACROBUTTON [b2] "Click Here and Type"  b.Attitudes regarding termination of parental rights and adoption.  MACROBUTTON [b2] "Click Here and Type"  c.Preparation of child for adoption.  MACROBUTTON [b2] "Click Here and Type"  d.Possibility of adoption by relative network or foster parents.  MACROBUTTON [b2] "Click Here and Type"  e.Efforts made to place the child(ren) for adoption or within the relative network. Statement of the efforts made to place the child(ren) for adoption or within the relative network.  MACROBUTTON [b2] "Click Here and Type"  f.Compelling Reasons. Document the compelling reasons why it is not in the childs best interest to be placed for adoption or within the relative network.  MACROBUTTON [b2] "Click Here and Type"  B.TFC Foster Parent Input Attach written input from the TFC foster parent(s) for the child(ren). If a written statement from the TFC foster parent(s) is not available, summarize the foster parents feedback.   MACROBUTTON [b2] "Click Here and Type"  V.RECOMMENDATION Recommendations to Court, if applicable. For each child, indicate whether the child should remain in placement, under the supervision of the courts, as appropriate or as State Wards. Request any other orders from the court as appropriate.   MACROBUTTON [b2] "Click Here and Type"  Department of Human Services of MichiganPermanent Ward Treatment Plan and Service AgreementThis treatment plan is developed to assure that each child will receive safe and proper care and services by the following activities. Service Type Code:AD =Alcohol or Drug Abuse RehabilitationFR =Reunification ServicesIL =Independent Living ServicesOT =Other Program NeedsDC =Day CareFC =Family Counseling/Outreach CounselingJT =Job Training/Employment AssistancePS =Parenting Skills TrainingED =EducationHS =Homemaker Services or Parent AidesMH =Mental Health ServicesTH =Individual/Group TherapyDV =Domestic Violence ProgramMD =Medical ServiceWP=WraparoundA. SERVICE REFERRAL TABLE Using the codes above for member referred and service provider type, enter the information for all services below. To enter additional services for following reports, place the cursor in the FIRST FIELD of the row ABOVE where you want the new row and click the Insert Svc Ref Row button to insert services between rows as needed. To enter continued headings, click in the FIRST FIELD on the new page and click the ADD SVCREF HEADING button. To remove continued headings, click the REMOVE SVC REF HEADING.  Family Member Name Barriers/ Needs Addressed  Service Type Code  Service Provider Name  Mo/Yr Re- ferred  Mo/Yr Start Target Com- pletion Date (Mo/Yr) Service Status  Completed Services  Com- pletion Date (Mo/Yr)  FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       Permanent Ward Treatment Plan and Service Agreement (continued) B. Treatment Foster Parent Activities and Discipline and Child Handling Techniques1. List each goal for foster parent, specific action steps, time frame for achieving, and expected outcome. ( Participation and attendance in all treatment meetings ( Implementation of in-home portion of treatment plan ( Strategies utilized to assist the child in placement ( Identify interventions to be utilized to assist the planning family in managing the childs needs ( Identify activities the TFC parent will provide to nurture the childs pro-social network and to nurture the childs interests and talents ( Identify behavior logging expectations 2. Describe the discipline and child handling techniques to be used while the child is in placement. 3. Describe the plan of supervision for the child while in placement. 4. Describe the plan for acceptable activities such as baby sitting, routine household tasks, privileges etc. Justify the tasks and/or additional expenses provided by the caregiver that justifies the Determination of Care Supplement. If the youth is age 14 or older, detail the independent living preparation activities the foster parent/relative caregiver will provide to assist the youth. (See CFF 722-6 Independent Living Preparation.)   MACROBUTTON [b2] "Click Here and Type"  C. Individual Child ActivitiesDescribe all activities to achieve the permanency planning goal. List for each child, the service goals and action steps, time frame for achieving, and expected outcome. Goals should address areas prioritized on Child Needs and Strengths Assessment and activities of daily living (if applicable). 1. Identify short term treatment goals, interventions and outcomes for childs treatment in the TFC program. 2. Identify what the agency and the provider need to do to meet these specific needs. 3. Address sibling visitation, if siblings are split. When separated, the relationship between siblings, must be maintained by detailed plan of visits, phone calls and letters. 4. For each ward age 14 or older (including those wards who become 14 years of age during the report period), include a description of the programs and services which will assist the youth to prepare for transition to a state of functional independence or the ability to take care of oneself physically, socially, economically and psychologically. Identify where, how and by whom these services are to be provided. (See CFF 722-6 Independent Living Preparation.)   MACROBUTTON [b2] "Click Here and Type"  D. Treatment Foster Care Worker Activities1. Identify services to be provided to the child and to treatment foster parents / relative caregiver / planning family by the TFC worker. State activities which support the services offered. 2. State proposed TFC worker contact with the family, child, caretakers, and service provider, if applicable. 3. If the youth is age 14 or older, detail the independent living preparation activities that the worker will provide to assist the youth. (See CFF 722-6 Independent Living Preparation.)   MACROBUTTON [b2] "Click Here and Type"  E. Behavioral Aide ActivitiesDescribe activities the behavioral aide is responsible for implementing including frequency of contacts and with whom.  MACROBUTTON [b2] "Click Here and Type"  F. Aftercare PlanIdentify recommended after care services including nature of services, frequency, duration and person responsible for aftercare services.  MACROBUTTON [b2] "Click Here and Type"  The development of this plan was negotiated with: (also list those individuals who were unavailable to participate in the development and why not). Youth age 14 and older must be involved in the development of the plan and be responsible for its implementation with the assistance of identified individuals. Upon clicking in the Name and Title field below, a question box allows addition of a signature line for Youth Age 14 and Older, if applicable and/or additional Other Agency Worker Name rows.  MACROBUTTON [b2] "Click Here and Type"  CLICK HERE TO ADD YOUTH SIGNATURE FOR YOUTH AGE 14 AND OLDER  FORMTEXT ,XZnpr|~  X z | Ԍتwl؅awhTthg"OJQJj@hiUhTthg"5CJOJQJ hTthg"jhiUhTthg"5hTthacOJQJ hTthacjh8!`hvpB* UphfjhW^UjhiUhvpjhvpUhTthac5CJOJQJhTthacCJhTth dCJ$,X } /$Ifgdac]kd$$IflF*l +    4 la $Ifgdac $Ifgdac 2$Ifgdac . X z $Ifgdac $Ifgdac /$Ifgdp]kd$$IflF*l +    4 la $Ifgdac $Ifgdac /$Ifgdac]kd$$IflF*l +    4 la  * , @ B D N P R T V ~    ĹݮݢĹݗҢĹ݌ݢݢynjhTth~UhTth~CJhTth~5CJjhiUjohiUhTthg"5OJQJjhiUjhTthg"UhTthg"5CJOJQJhTthg"OJQJ hTthg"jhW^UjhvpUjhiU*  * R $Ifgdac $Ifgdac /$Ifgdac]kd[$$IflF*l +    4 laR T V ~ 1]kd $$IflF*l +    4 la $Ifgdac $Ifgdac]kd$$IflF*l +    4 la ]kdb $$IflF*l +    4 la $Ifgdac $Ifgdac  D J $Ifgd~ $Ifgd~]kd $$IflF*l +    4 la 2 4 6 @ B D H J L ` b d n p t ȿ|ofYfIYj{ hTth~CJUjhTth~CJUhTth~CJhTth~CJOJQJhTth~5CJOJQJ$hTth~<B*CJOJQJph'hTth~5<B* CJOJQJphfjB hTth~UhTth~CJhTth~5CJjhUUmHnHujhTth~Uj hTth~U hTth~  wwdL$Ifgd~ $Ifgd~pkd $$Ifl\0?*Q]+4 la      2 5 A B µs`sPBPBPBhTthG>*CJOJQJhTthG5>*CJOJQJ$hTthac<B* CJOJQJphfhTthacCJOJQJhTthac5OJQJhTthg"OJQJhTthg"5OJQJ hTthg"hTth~OJQJhTth~CJOJQJ hTth~ hTth~<B* OJQJphfhTth~CJjhTth~CJUjhUCJUmHnHu      sj09kd $$Ifl*++4 la $Ifgdac7kd $$Ifl*++4 la $Ifgd~Jkd1 $$Ifl0\*@$+4 la 3 4 5 A B HMkd$$Ifl0**%+4 layt[ $$Ifa$gdac $IfgdacMkd&$$Ifl40*+4 laf4$If  .D$pp$If]p^pa$gdo$pp$If]p^pa$gd v DFH\^`jlnpпs_Ks&jehTth5oUmH nH u&jhTthGUmH nH uhTthGmH nH u jhTthGUmH nH u hTthGjhUU&jhTth5oUmH nH uhTth5omH nH u jhTth5oUmH nH uhTthG>*CJOJQJhTthG5>*CJOJQJ"hTthG5>*@CJOJQJDFn*!! ?$Ifgd vkd$$Ifl F~ az 3%*8/d8i+$$$$4 layt[6^ ?$Ifgdo ?$Ifgd v  $&(2468LNPZ\^`tvxp\&j[hTthGUmH nH u&jhTthGUmH nH u&johTthGUmH nH u&jhTthGUmH nH u&jhTthGUmH nH uhTthGmH nH u hTthGjhUU jhTthGUmH nH u&j hTthGUmH nH u$~dzt`YtEYt&jhTth[=UmH nH u hTth[=&j)hTth[=UmH nH uhTth[=mH nH u jhTth[=UmH nH uhTtho>*CJOJQJ&hTth~5>*CJOJQJ^JaJ&hTtho5>*CJOJQJ^JaJ hTtho#hTthGCJOJQJmHnHu hTthGjhUU jhTthGUmH nH u,# ?$Ifgd vkd$$Ifl F~ az 3%*8/d8i+$$$$4 layt[4b$$If]^a$gd v $$Ifa$gd v<kd$$Ifl*++4 layt[:^D;;;;; ?$Ifgd vkd#$$Ifl ֈ 6x**:>Bz  +4 lap<yt[(*,68:<XZ\^`|~46J}iXLhTth7L[mH nH u jhTth7L[UmH nH u&hTth7L[5>*CJOJQJ^JaJhTth[=CJOJQJ jhUUmH nH u j]hUUmH nH u&jhTth[=UmH nH uhTth[=mH nH u hTth[=jhUU jhTth[=UmH nH u&jWhTth[=UmH nH u^=4 ?$Ifgd vkd$$Iflֈ 6x**:>Bz  +4 lap<yt[ ?$Ifgd[=244nkd$$IflF *`  +    4 lapyt[ $Ifgd7L[$If]^gd7L[Ckd$$Ifl*++4 lap yt[JLNXZ\^rtv̞wp_S?_&j!hTth[=UmH nH uhTth[=mH nH u jhTth[=UmH nH u hTth[=hTth7L[CJOJQJ juh#UmH nH uh +3BN~k~k~Z!hTth dB* CJOJQJphf$hTth|@J<B* CJOJQJphf$hTth d<B* CJOJQJphf'hTtho5<B* CJOJQJphfhTtho5CJOJQJhTthoCJOJQJ hTthohTthrCJOJQJhTthr5CJOJQJhTthrB*ph hTthrjhTthrU  !"#$$IfgdrF^Fgdr7kd($$Ifl**4 la $$Ifa$gdr $%)<{ul $$Ifa$$Ifkd)$$Iflr 4$* T _*4 la<=>DJ`kd*$$Ifl4FB*%*    4 laf4$IfMkd)$$Ifl40B*Q(*4 laf4   }}w$If8^8`kd*$$Ifl4FB*%*    4 laf4$ & F$Ifa$gd d $$Ifa$ "789:;AVWXY"#߿߰uj\hTth d5CJOJQJhTth 1B* phfh*<B* phfhTth*<B* phfh 1<B* phfhTthr<B* phfhTth 1<B* phfhTth 1<B* CJphfhTth 1CJOJQJhTth 15hTth 1B*ph hTth 1jhTth 1UhTth 15CJOJQJ :;<AV$If$If8^8[kd+$$Ifl4F>|)%    4 laf4VWXY wZd8$If^Z`gd*Zd8$If^Z` d$If $d8$Ifa$Mkd+$$Ifl40:x)y(4 laf4" /tF <!D%'()$Ifgd^ $Ifgd^gd dMkd+$$Ifl40: x)n(4 laf4$%&wUUU" /tF <!D%'()$Ifgd^ $Ifgd^X^Xgd*ukdf,$$Ifl4 \D$*p p p 4 laf4 &'():OPQSTuvwxɴڦɴڦɴڦɴڦ{nhTth 1CJOJQJhTth 15 hTth 1hTth|@J5CJOJQJhTth d5CJOJQJhuxCJOJQJ^JaJ)huxhuxB*CJOJQJ^JaJph huxhuxCJOJQJ^JaJ)jhuxhuxCJOJQJU^JaJhuxhTth dCJOJQJ+&'(RSTUstwnLL" /tF <!D%'()$Ifgd^ $Ifgd^X^Xgd*X^Xgduxukd,$$Ifl4 \D$*p p p 4 laf4tuvwg^^^UL $Ifgd^X^Xgd*X^Xgduxukdd-$$Ifl4 \D$*p p p 4 laf4" /tF <!D%'()$Ifgd^g^^^UOO$IfX^Xgd*X^Xgduxukd-$$Ifl4 \D$*p p p 4 laf4" /tF <!D%'()$Ifgd^   $Ifpkdb.$$Ifl\>=|)?4 la$If  "#$%)*-[\: ||h|TC!haA5<B* CJOJQJphf'hTth;M5<B* CJOJQJphf'hTthD5<B* CJOJQJphf'hTthJ 5<B* CJOJQJphf'hTth 15<B* CJOJQJphf'hTth d5<B* CJOJQJphfhTth d5CJOJQJhTth 15>*CJOJQJhTthD5CJOJQJhTth 1CJOJQJhTth 15CJOJQJ   #$%&'J`kd\/$$Ifl4F>|)%    4 laf4$IfMkd.$$Ifl40>|)y(4 laf4'*[:!] $$Ifa$gdg"$ & F h $If^ a$gd~|$ @H$If^`Ha$gd d$ @$Ifa$gd d$If KLNʿ~q~c~OOOOq'hTth^5<B* CJOJQJphfhTth^5CJOJQJhTth dCJOJQJhTth d5CJOJQJhTthaA5CJOJQJh2hTth2B*phhYi hTth2jhTth2UhaA5CJOJQJhTth 1CJOJQJ'hTth d5<B* CJOJQJphf'hTth|@J5<B* CJOJQJphf}}tttd$ $Ifa$gd d $Ifgd^^gd2gd^skd/$$Ifl4\>|)"4 laf4 LMNOz{|}ge__eY$If^skdV0$$Ifl4\>|)"4 laf4 $$Ifa$gd^$ & F @ $If^ a$gd~| NOPbwxyz{}~񫗃vbvUMhTth:5jhTth:5U'hTthJ 5>*B*CJOJQJphhTthJ CJOJQJ'hTth 15<B* CJOJQJphf'hTthJ 5<B* CJOJQJphf'hTth5<B* CJOJQJphfhTth 1CJOJQJhTth 15hTth 1B*ph hTth 1jhTth 1UhTth 15CJOJQJ}~|eee$ & F h^$If^^a$gd~|skd0$$Ifl4\>|)"4 laf4 $$Ifa$$If vvjjjjj $$Ifa$gdH $IfgdHskdX1$$Ifl4\>|)"4 laf4 $$Ifa$gdJ  6 SJJ>55 $IfgdH $$Ifa$gdH $IfgdHkd1$$Ifl֞>Dd#|) ~ 4 la   $ & ( 2 4 6 8 L N P Z \ ^ ` t v x ̿Կ̊̚Ԛ̚zԚm`XMhTthOJQJhTth5hTthCJOJQJhTthJ CJOJQJj4hTthJ 5Uj3hTthJ 5UjhTthJ 5Uj23hTthH5UhTthH5jhTthH5UhTthJ 5jhU5UmHnHujhTth:5Uj2hTth:5U6 ^ JAA5 $$Ifa$gdH $IfgdHkdp4$$Ifl֞>Dd#|) ~ 4 la $IfgdH JAA $Ifgd|jkdF5$$Ifl֞>Dd#|) ~ 4 la $IfgdH .!0!2!!!!h[[YY   @ ^ gdrakskd6$$Ifl4\>|)"4 laf4$ & F h^$If^^a$gd~| $$Ifa$gd|j ,!.!0!2!4!X!!!!!!!!!!!!!x"ï󨝨xjׅjWC'hTthg"5<B* CJOJQJphf$hTthg"5B* CJOJQJphfhTthg"5CJOJQJhTthrakCJOJQJhTthg"CJOJQJhTthrakB*phjhTthrakU hTthrak'hTth|j5<B* CJOJQJphf'hTth5<B* CJOJQJphfhTth5CJOJQJhTth|j5CJOJQJhTth|jCJOJQJ!!!!!!""J"x""""#)#z$ & F$Ifa$gd7$ & F $Ifa$gdg"$ & F $Ifa$gdg"$ & F $Ifa$gdg"$ & F @$Ifa$gdg"$ @$Ifa$gdg" $$Ifa$gdg" $$Ifa$gdp $Ifgdpx""""#(#)#m#o#q#r##########$$$$'$<$=$>$A$C$E$F$\$ö~~ÌwlwawlwSShTthg"5CJOJQJhTthB*phjhTthU hTthhTth5CJOJQJhTthCJOJQJhTthg"B*phjhTthg"U hTthg"hTthg"CJOJQJ'hTth5<B* CJOJQJphf'hTthg"5<B* CJOJQJphf'hTth75<B* CJOJQJphf )#m#n#o#p#q####lccZUUgd~ ^~ gdg"F^Fgdg"rkd6$$Ifl\D*"4 la$n$If^na$gdp$ & F$Ifa$gd7######$$$Wrkd 7$$Ifl\D*"4 la$n$If^na$gdXd$ & F$Ifa$gdXd $$Ifa$gdXd $IfgdXd$$$?$@$A$B$C$F$\$]$$$&%'%$ & F$Ifa$gdg" $$Ifa$gdg" $$Ifa$gdp $Ifgdp~ ^~ gdF^Fgd\$]$q$$$$$$$&%(%*%+%<%Q%R%S%V%X%Z%[%z%{%%%&&dzdz۟uggYǟE'hTth|@J5<B* CJOJQJphfhTthp5CJOJQJhTthg"5CJOJQJhTthg"B*phjhTthg"U hTthg"hTthg"CJOJQJ'hTth |5<B* CJOJQJphf'hTthD5<B* CJOJQJphf'hTthp5<B* CJOJQJphf'hTthg"5<B* CJOJQJphfhTthg"5CJOJQJaJ'%(%)%*%T%U%V%W%X%[%z%{%zzzqqqee $$Ifa$gdp $Ifgdp~ ^~ gdg"F^Fgdg"rkd|7$$Ifl\D*"4 la {%%&J&~&&&&&&&pgg^~ ^~ gdg"F^Fgdg"rkd7$$Ifl\D*"4 la $$Ifa$gdp$ & F $Ifa$gdp &$&6&9&:&>&&&&&&&&&&&&&&&&& 'A((׶~pbT~T@'hTth 15<B* CJOJQJphfhTth 15CJOJQJhTthp5CJOJQJhTthFq5CJOJQJhTth 1CJOJQJ hTth7 hTthvhTthg"B*phjhTthg"U hTthg"hTthg"CJOJQJ'hTth|@J5<B* CJOJQJphf'hTth |5<B* CJOJQJphf'hTthCD5<B* CJOJQJphf&&&&&&&&&&&&& 'sskdb8$$Ifl4\>|)"4 laf4 $$Ifa$$If~ ^~ gdg" ''A((((((KE~ ^~ kd8$$Ifl4r>$ |)X 4 laf4$z$If^za$gdCD $$Ifa$$ & F$If^a$gd~|(((((((())))))*)2)>))))*D**#+++Q+s__G_/hTth 15<@B* CJOJQJaJphf'hTthQD\5<B* CJOJQJphfhTthQD\5CJOJQJhTth 15CJOJQJhTth 15hTth 1B*phjhTth 1U hTth 1hTth 1CJOJQJ*hTth |5<B*CJOJQJ\ph'hTth |5<B* CJOJQJphf'hTth 15<B* CJOJQJphf()))))))>))*D**R+$ & F$If^a$gd~| $$Ifa$$If~ ^~ Q+R+S+T+U+g+|+}+~+++++++++++,,,,,׹ޫwwwdP?!hTt5<B* CJOJQJphf'hTthTt5<B* CJOJQJphf$hTth 15B* CJOJQJphf$hTthCD5B* CJOJQJphf$hTth |5B* CJOJQJphfhTth |5CJOJQJhTth 15CJOJQJhTth 15hTth 1B*phjhTth 1U hTth 1hTth 1CJOJQJ'hTth 15<B*CJOJQJphR+S+T++++++++,}wwwuoofff $$Ifa$$If~ ^~ kdl9$$Ifl4r>$ |)X 4 laf4 ,h,,,,,,$-%-YSSJ~ ^~ gd |~ ^~ kd9$$Ifl4r>$ |)X 4 laf4$V$If^Va$gd |$ & F$If^a$gd~|,,,,,,, -!-"-#-$-%-(-P-.... ..ƹyeQJ?JjhTth |U hTth |'hTth |5<B*CJOJQJph'hTth |5<B* CJOJQJphfhTth |5CJOJQJhTth |CJOJQJhTth |5hTth 1B*phjhTth 1U hTth 1hTth 1CJOJQJ'hTth 15<B*CJOJQJph'hTth7L[5<B* CJOJQJphf!h7L[5<B* CJOJQJphf%-&-'-(-)-,-P--..$ & F$If^a$gd~| $$Ifa$gdXd $IfgdXdgd | ...3.4.5.6.7.:.K..}tttrllccc $$Ifa$$If~ ^~ gd |kd:$$Ifl4r>$ |)X 4 laf4 .0.1.2.3.4.7.8.9.:.K....///0*050011111111111111Ϳͱ͂wlwdͿhTth 15hTth 1B*phjhTth 1U hTth 1'hTth?M5<B* CJOJQJphf'hTth 15<B* CJOJQJphfhTth 15CJOJQJhTthFq5CJOJQJhTth 1CJOJQJhTth |5jhTth |U hTth |hTth |B*ph"./v/w/z/{//001111$ & F$If^a$gd~| $$Ifa$$ & F$If^a$gd~| 11111111111}}ttt $$Ifa$$If^skd;$$Ifl4\>|)"4 laf4 11111 2vk "$IfgdD $$Ifa$gdD $IfgdDskd;$$Ifl4\>|)"4 laf411 222M2N2O2P2b2w2x2y2z2{222222222222222333303E3F3G3H3I3J3M333333333źŲޗźŲ|źŲ|źhTth;M5CJOJQJhTth;MCJOJQJhTth 15CJOJQJhTth 1CJOJQJhTth 15hTth 1B*ph hTth 1jhTth 1U hTthrakhTthD5CJOJQJ hTthDhTthDCJOJQJ0 2 22222M2vvm $IfgdD $$Ifa$gdD $IfgdDskd<$$Ifl4\>|)"4 laf4M2N2O2z2{2|2}2~222xooic]]TT $$Ifa$$If^^ ^ gd;Mkd<$$Ifl4r>R |)* 4 laf4 22222222222tnnnlff$If~ ^~ kd=$$Ifl4r>R |)* 4 laf4 $$Ifa$ 2333H3I3J3K3L3M3lfffd^^U $$Ifa$$If~ ^~ kd=$$Ifl4r>R )M 4 laf4 $$Ifa$gd;M M3P333333333c]]][UU$If~ ^~ kd>$$Ifl4r>R |)* 4 laf4 $$Ifa$gd;M $$Ifa$ 3333344 44g4o4y4z4{4|444444444455=5G5I5J5\5q5r5s5t5u5v5z5~5ȺȘynyȘyny`hTthmA5CJOJQJhTth 1B*phjhTth 1U'hTthQD\5<B* CJOJQJphf'hTth 15<B* CJOJQJphfhTthQD\5CJOJQJhTth?M5CJOJQJhTth 15CJOJQJhTthD5CJOJQJhTth 1CJOJQJhTth 15 hTth 1%3334y4z4{44444oicc]W$If ^  ^  ^ kd>$$Ifl4r>R |)* 4 laf4 $$Ifa$ 44444G5H5I5t5u5v5w5nlff` ^  ^ kd?$$Ifl4r>R |)* 4 laf4 $$Ifa$$If w5z555J6K6L6M6x6y6z6}6668^8[kd?$$Ifl4F>|)%    4 laf4%$If $$Ifa$ ~5555555J6K6M6N6`6u6v6w6x6y6z66667777777777777Ժ䯨m䯨ahTthQD\5OJQJ'hTth 15<B*CJOJQJph'hTth 15<B* CJOJQJphfhTth 15hTth 1B*ph hTth 1jhTth 1UhTth 15CJhTthmA5<B* CJphfhTth 15<B* CJphfhTth 1CJOJQJhTth 15CJOJQJ!6666H77777JHHkdx@$$Ifl40>|)y(4 laf4$ & F$If^a$gd~| $$Ifa$$IfHkd@$$Ifl40>|)y(4 laf477777777777^skd@$$Ifl\ b,:WW\E O94 la yt8"K $$Ifa$ $$Ifa$$If$If$^a$h^h 7777788888888888888888$9&9w9y9992:4:m:{:::: ;;;<<<M=ᦴqihTthVm]5hTth 1<B*CJph&hTth 15;<B* OJQJphf#hTth 15<B* OJQJphfhTth 15CJOJQJhTth 15CJOJQJhTth 1mH nH uhTth 16hTth 1OJQJ hTth 1hTth 1OJQJhTth 15OJQJ)78888888| %d$If$If`kdjA$$IflFh,:h3 O9    4 la yt8"K$If $$Ifa$888888|$If$IfvkdA$$Ifl4\ ,.:W$A O94 la f4yt8"K888888G> ?$$Ifa$:kd"C$$Ifl:O9O94 la yt8"K$IfvkdB$$Ifl4\ ,.:W$A O94 la f4yt8"K88888889 9%9yo $If]?kdC$$Ifl4$:O9O94 la f4yt8"K$If?kdvC$$Ifl4$:O9O94 la f4yt8"K %9&9+9?9D9M9R9x9`ZZZZZZ$Ifkd2D$$Ifl4$ֈVf!$:* O94 la f4yt8"Kx9y9999999`ZZZZZZ$IfkdD$$Ifl4$ֈVf!$:* O94 la f4yt8"K99999::3:`ZZZZZZ$IfkdE$$Ifl4$ֈVf!$:* O94 la f4yt8"K3:4:::T:Y:i:m:x:`ZZZZZZ$IfkdF$$Ifl4$ֈVf!$:* O94 la f4yt8"Kx:y:z:{:`Z=kd.H$$Ifl4:O9O94 la f4yt8"K$IfkdbG$$Ifl4$ֈVf!$:* O94 la f4yt8"K{:::: ;;;T<<< & F $If V$If^V & F$If $$Ifa$=kdH$$Ifl4:O9O94 la f4yt8"K$If <<<<<<<<<<<<<<<<<<<<< $$Ifa$ $$Ifa$=kdH$$Ifl4@87O94 la f4yt8"K<<<=== ====="=*=0=8=9=:=B=I=J=K=L=M=W=`=a=b=c= $$Ifa$ $$Ifa$M=W=====> > >>>,>.>0>2>4>P>R>T>V>X>l>n>p>z>|>~>>>>>>>>>>>>>>>>>۴ۗۉ{mj*RhTthVm]UjQhTthVm]UjVQhTthVm]UjbNhUUjKhUU hTthjhTthUjhUUmHnHujJhTthVm]U hTthVm]jhTthVm]UhTthVm]5hTthVm]5@*c=h=r=w=== $$Ifa$ $$Ifa$==>$Ifkd2>V>~>>>>?>?f? $$Ifa$$If >>>>>>>?????8?:??@?T?V?X?b?d?h?j?~??????????????ѻѰذѓvk`jZh8"KUjlWh8"KUjh8"KUmHnHujVh8"KUh8"Kjh8"KUj UhTth_jU hTthjjhTthjUjbThUUjRhUU hTthVm]jhUUmHnHujhTthVm]UjRhTthVm]U%f?h??$IfkdU$$Ifl Vz(#R&|),815@82 p$ ****O9((((4 la yt8"K???@(@P@x@@@@ $$Ifa$$If ?????????@@@@@$@&@(@*@>@@@B@L@N@P@R@f@h@j@t@v@x@z@@@@@@@@@@@@@@@@@@AA󐌁jch Uh jh Uj6ah8"KUj`h8"KUj*_h8"KUj^h8"KUjV^h8"KUj]h8"KUjh8"KUmHnHuj]h8"KUh8"Kjh8"KU2@@A$Ifkda$$Ifl Vz(#R&|),815@82 p$ ****O9((((4 la yt8"KAAAAAA0A2A4A6A8ATAVAXAZA\ApArAtA~AAAAAAAAAAAAAAAAAAAAAAAAABBBB BB@BBBDBXBjlh Uj4kh Ujjh Uj`jh Ujih Ujih Ujfh Ujvch Uh jh UmHnHujh U6A6AZAAAAABBBjB $$Ifa$$If XBZB\BfBhBlBBBC,CCC*DHDIDKDLDMDNDrDzD{DDDDDDDDDDEӽveTe hTthCD<B* OJQJphf hTth|@J<B* OJQJphf hTthXd<B* OJQJphf& jhTthmA<B* OJQJphf hTthmA<B* OJQJphf hTth 1<B* OJQJphfhTth 15 hTthr hTthi hTth 1h jh UmHnHujh Uj@mh UjBlBkdm$$Ifl Vz(#R&|),815@82 p$ ****O9((((4 la yt8"KlBnBpBrBtBvBxBzB|B~BBBBBBB C CC5kdr$$Ifl4|))4 laf4 %$$Ifa$%dPFfp$If $$Ifa$CCCIDDDD[EELLLLL<$ Mi8 I W*P X !$%`'@8$If^8`a$gdmA:$ Pi I W*P X !$%`'$If^`a$5kd]r$$Ifl4|))4 laf4%$IfEE=E>E]E^EEEFF,G-G.GGHHXHvHyHzH|H}HH޹޹ިͅtbWPEPjhTth 1U hTth 1hTth 1B* phf#hTth 15<B* OJQJphf hTthQD\<B* OJQJphf hTth<B* OJQJphf#hTth 1<B* OJQJhphf hTth 1<B* OJQJphf& jhTthmA<B* OJQJphf hTthCD<B* OJQJphf hTthmA<B* OJQJphf hTth`<B* OJQJphfEFzFFGGyHzHL<$ Mi I W*P X !$%`'h$If^h`a$gdmA:$ Pi I W*P X !$%`'$If^`a$<$ Mi8 I W*P X !$%`'@8$If^8`a$gdmAzH{H|HHHHHH I|h= wn$If^n`5kdr$$Ifl4|))4 laf4%$Ifh^hgd h^h5kdr$$Ifl4|))4 laf4HHHHHH IIeJJJkKlKM8M;MM?MQMfMgMhMiMkMpMzMMMMMMMMǶڶp_ hTthQD\<B* OJQJphf hTthTt<B* OJQJphf hTthmAhTth 1B* phf#hTth 15<B* OJQJphf hTthCD<B* OJQJphf hTth 1<B* OJQJphf$hTth 1<B* CJOJQJphfhTth 15jhTth 1U hTth 1hTth 1B*ph! I IxIIdJJkK;MMiMjMkMMMZNF9$ Mi I W*P X !$%`'$If^`a$5kds$$Ifl4|))4 laf4%$Ifh^hh^h5kdJs$$Ifl4|))4 laf4MNNNmNpNeOOOOOOOOOOOOOOMPNPPPQPcPxPyPzP{P}PPPQQQQ1QFQGQHQJQ}rgr}rgrhTth`B*phjhTth`UhTth`B* phfhTth`<B* phf hTth`hTth`5hTth 1B*phjhTth 1U hTth 1hTth 1B* phf#hTth 15<B* OJQJphf hTth 1<B* OJQJphf hTth|@J<B* OJQJphf(ZN[NNNOOOOOUOIh^hh^h5kds$$Ifl4|))4 laf4%$If9$ Mi I W*P X !$%`'$If^`a$5$ Mi I W*P X !$%`'$If^a$OOOOONPOPPP{P|P}PPofh^hgd`5kdt$$Ifl4|))4 laf4 %h$If^hgd`5kd7t$$Ifl4|))4 laf4 %$IfgdXdgd`h^hgd` PPQQQIQJQKQR?S}ttrll%$Ifh^hgd`h^hgd`5kd$u$$Ifl4|))4 laf4 %h$If^hgdXd5kdt$$Ifl4|))4 laf4 JQR?SBSCSUSjSkSlSoSSSSSSTnnnn n n*n,n.n0nøvof\fUHjhTtht 85U hTthaXhTthaX5CJhTthaXCJ hTtha#jhUB*UmHnHphuU$juhTth B*UphhTth B*phjhTth B*UphhTthaB*ph$hTtha5B*CJOJQJphhTth 1B*phjhTth 1UhTth 1<B* phf hTth 1?S@SASBSmSnSoSn n n,n.nmgga$If#$IfGkdZv$$Ifl(X)   X)4 lap  x$Ifgdah^h5kdsu$$Ifl4|))4 laf4    Name and Title:  FORMTEXT       Signature: Date:  FORMTEXT       DHS Local Office Name:  FORMTEXT      DHS Local Office Approval: Name and Title:  FORMTEXT       Signature: Date:  FORMTEXT       FORMTEXT       Distribution of Plan:   MACROBUTTON [b2] "Click Here and Type"  The local office shall approve, or disapprove, in writing, the PWSP for a child in purchased foster care or residential care. The Purchase of Service (POS) agency is responsible for all elements of the service plan in cases where they have accepted responsibility for providing family services per the DHS-3600 (RFF 3600) contract. The local office is responsible for reporting requirements only when the POS agency has not accepted total case responsibility. The report from the local office should not duplicate the POS agency report, but should address those areas for which the POS agency is not responsible per the DHS-3600 contract. Signing the PWSP submitted by the POS agency indicates approval. The approved PWSP is to be returned to the POS agency within seven days of receipt; a copy is retained in the child s case record. The local office is responsible for knowing what services are being purchased from the POS agency and for monitoring compliance with the DHS-3600. When a noncompliance situation is identified, it is to be brought to the attention of the POS agency both verbally and in writing. If efforts to resolve the area of conflict locally are not successful, the situation is to be brought to the attention of the appropriate Zone Office. If Zone Office is unable to intervene successfully, then the Office of Child and Family Services is to be involved. (See CFF 914, Monitoring Worker Responsibilities for more information.) Department of Human Services (DHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or expression, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you are invited to make your needs known to a DHS office in your area.AUTHORITY: P.A. 280 of 1939. RESPONSE: Voluntary. PENALTY: None     DHS-68A (Rev. 3-10) Previous edition obsolete. MS Word  PAGE 1 DHS-68A (Rev. 3-10) Previous edition obsolete. MSWord  PAGE 8 0nDnFnHnRnTnVn\n^nrntnvnnnnnnnnnnnnnnnnnnü̘üxjxcVNhTtha5jhTtha5U hTthahTtha5CJOJQJhTthaCJOJQJ hTth(|j/xhTthaX5UjhTthaX5UhTthaX5CJhTthaXCJ hTthaXhTthaX5jhU5UmHnHujhTtht 85UjvhTtht 85UhTtht 85.nVnXnZn\n^ntnvnxnnnn||t|$If#$Ifpkdw$$Ifl\(. [ X)4 la$If$If nnnnnnnKBB9 $Ifgda $Ifgda9kdZy$$Ifl (X)X)4 la $Ifgd(|pkdx$$Ifl\(. [ X)4 lanno o oooooLoPoRoporotovooooooooooooooo̿~pbUMhTth8q5jhTth8q5UjhUUmHnHuj~{hTthlNU hTthlNjhTthlNU hTth8qhTth8q5CJhTth8qCJhTtha5CJOJQJ hTthahTthaCJOJQJhTtha5jhU5UmHnHujhTtha5UjyhTtha5UnooooooNoz@9kdz$$Iflh(X)X)4 larkdGz$$Iflh\5(  X)4 la $Ifgda $IfgdaNoPoRorotoooo $Ifgd8q $Ifgd8q #$Ifgd8q9kd1{$$Iflh(X)X)4 laooooooooozqqh $Ifgd8q $Ifgd8q $Ifgd8q #$Ifgd8qpkdd|$$Ifl\(. [ X)4 laoooooooo ppppp"p&pRpTpVpXpZp~ppppppźŬŗ|uju_ujXMhTth_jB* phf hTthFhTth_jB*phjhTth_jU hTth_jhTthaCJOJQJhTtha5CJOJQJ hTthajhUUmHnHuj~hTth8qUjhTth8qU hTth8qhTth8q5jhU5UmHnHujhTth8q5Uj|hTth8q5Uoop p"p$p|A8 $Ifgda:kd$$Ifl4(X)X)4 laf4 $Ifgd8q $Ifgd8qpkde}$$Ifl\(. [ X)4 la$p&pRpTpVpXppp@wBw| |~upnnnngd_j^gd_jdgd_j7kd$$Ifl(X)X)4 la $Ifgda7kd_$$Ifl(X)X)4 la pdrfrssuuVx\x |  "@Āƀ̀Ѐ»vrjbjWhg"h,jCJaJhaxCJaJh,jCJaJh,jhax0J8CJmHnHuh,j0J8CJjh,j0J8CJU h,jCJ haxCJh=jh=Uh5B5z 5 #v*#v:#v>#vB#vz #v :V l +,5*5:5>5B5z 5 4p<yt[D Enter Child's NameD$Enter Child's Date of BirthD Enter Child's Case NumberjD Df Dropdown5  Parental HomeLic/Unlic RelativeLegal Guardian Adoptive HomeLic Unrelated Foster Home Ind LivingUnrelated CaregiverOtherDf Dropdown5  Parental HomeLic/Unlic RelativeLegal Guardian Adoptive HomeLic Unrelated Foster Home Ind LivingUnrelated CaregiverOther$$If!vh5*5:5>5B5z 5 #v*#v:#v>#vB#vz #v :V l+5*5:5>5B5z 5 4p<yt[^$$If!vh5+#v+:V l+5+4p yt[$$If!vh5` 5 5#v` #v #v:V l+,5` 5 54pyt[vD Text61vDText62rDf Dropdown6 ReunificationAdoption Guardianship1Permanent Placement with Fit and Willing Relative APPLA/APPLA-Ey$$If!vh5` 5 5#v` #v #v:V l+5` 5 54yt[Q$$If!vh5+#v+:V l+5+4yt[DY$Child's Address (if not foster home)c$$If!vh5Y 5#vY #v:V l+5Y 54yt[Df Dropdown4Native American? Select response. To add additional child(ren) click or tab to Tribal Affiliation field and click Add Child Info button YesNoUnknownPendingDTribeUIf yes, Tribal Affiliation. To add additional child(ren) click Add Child Info button$$If!vh55"55#v#v"#v#v:V l (+55"554p(yt[a$$If!vh5+#v+:V l4+5+/ 4f4yt[S$$If!vh5+#v+:V l4+5+4f4yt[i$$If!vh55Z(#v#vZ(:V l4+55Z(4f4yt[y$$If!vh555%#v#v#v%:V l+555%4yt[$$If!vh555 5#v#v #v:V l55 54aL$$If!vh5*#v*:V l5*4a$$If!vh5 5T55 5_#v #vT#v#v #v_:V l*5 5T55 5_4c$$If!vh55Q(#v#vQ(:V l4*55Q(4f4y$$If!vh555%#v#v#v%:V l4*555%4f4y$$If!vh555%#v#v#v%:V l4*555%4f4~$$If!vh555%#v#v#v%:V l4555%4af4h$$If!vh55y(#v#vy(:V l455y(4af4h$$If!vh55n(#v#vn(:V l455n(4af4}$$If!vh55p 5p 5p #v#vp :V l4 ,55p 4f4}$$If!vh55p 5p 5p #v#vp :V l4 ,55p 4f4}$$If!vh55p 5p 5p #v#vp :V l4 ,55p 4f4}$$If!vh55p 5p 5p #v#vp :V l4 ,55p 4f4$$If!vh5555?#v#v#v#v?:V l5555?4ah$$If!vh55y(#v#vy(:V l455y(4af4p$$If!vh555%#v#v%:V l455%4af4$$If!vh5555"#v#v#v":V l4555"4af4$$If!vh5555"#v#v#v":V l4555"4af4x$$If!vh5555"#v#v":V l455"4af4x$$If!vh5555"#v#v":V l455"4af4$$If!vh5555 5~ 55#v#v#v#v #v~ #v#v:V l5555 5~ 554aDChild AddChildRowjDjD jD $$If!vh5555 5~ 55#v#v#v#v #v~ #v#v:V l5555 5~ 554a$$If!vh5555 5~ 55#v#v#v#v #v~ #v#v:V l5555 5~ 554ax$$If!vh5555"#v#v":V l455"4af4q$$If!vh5555"#v#v":V l55"4q$$If!vh5555"#v#v":V l55"4q$$If!vh5555"#v#v":V l55"4q$$If!vh5555"#v#v":V l55"4x$$If!vh5555"#v#v":V l455"4af4$$If!vh55555X #v#v#vX :V l4555X 4af4$$If!vh55555X #v#v#vX :V l4555X 4af4$$If!vh55555X #v#v#vX :V l4555X 4af4$$If!vh55555X #v#v#vX :V l4555X 4af4x$$If!vh5555"#v#v":V l455"4af4x$$If!vh5555"#v#v":V l455"4af4~$$If!vh5555"#v#v":V l4,55"4af4$$If!vh55555* #v#v* :V l455* 4af4$$If!vh55555* #v#v* :V l455* 4af4$$If!vh55555M #v#vM :V l455M 4af4$$If!vh55555* #v#v* :V l455* 4af4$$If!vh55555* #v#v* :V l455* 4af4$$If!vh55555* #v#v* :V l455* 4af4p$$If!vh555%#v#v%:V l455%4af4h$$If!vh55y(#v#vy(:V l455y(4af4h$$If!vh55y(#v#vy(:V l455y(4af4$$If !vh5W5W5\5E #vW#v\#vE :V lO95W5\5E 4a yt8"K~$$If !vh55h53 #v#vh#v3 :V lO955h53 4a yt8"K$$If !vh5W5$55A #vW#v$#v#vA :V l4O95W5$55A 4a f4yt8"K$$If !vh5W5$55A #vW#v$#v#vA :V l4O95W5$55A 4a f4yt8"KR$$If !vh5O9#vO9:V lO95O94a yt8"K\$$If !vh5O9#vO9:V l4$O95O94a f4yt8"K\$$If !vh5O9#vO9:V l4$O95O94a f4yt8"K$$If !vh555*5 55#v#v#v*#v #v#v:V l4$O9555*5 554a f4yt8"K$$If !vh555*5 55#v#v#v*#v #v#v:V l4$O9555*5 554a f4yt8"K$$If !vh555*5 55#v#v#v*#v #v#v:V l4$O9555*5 554a f4yt8"K$$If !vh555*5 55#v#v#v*#v #v#v:V l4$O9555*5 554a f4yt8"K$$If !vh555*5 55#v#v#v*#v #v#v:V l4$O9555*5 554a f4yt8"KX$$If !vh5O9#vO9:V l4O95O94a f4yt8"KX$$If !vh5O9#vO9:V l4O95O94a f4yt8"KX$$If !vh57#v7:V l4O9574a f4yt8"K^$$If !v h52 5p5$ 55*5*5*55 5 *#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a yt8"KvD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfDPopUpPrompt2.MAIN^$$If !v h52 5p5$ 55*5*5*55 5 *#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a yt8"KvD6Text11"Df C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD^$$If !v h52 5p5$ 55*5*5*55 5 *#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a yt8"KvD6Text11"Df C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD^$$If !v h52 5p5$ 55*5*5*55 5 *#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a yt8"K$$If !v h555p5$ 55*5*5*5 5 5 *#v#v#vp#v$ #v#v*#v #v #v *:V lO9555p5$ 55*5 5 5 *4a yt8"Kkd o$$Ifl 8 Vz(#R&|),815@8p$ ****O9,,,,4 la yt8"KM$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4M$$If!vh5)#v):V l45)4f4DText16AddYouthSignaturef$$If!vh5X)#vX):V l   X)5X)4p D- AddSignaturesEnter Foster Care Worker's NameAddSignatureAuto$$If!vh5. 5[55 #v. #v[#v#v :V lX)5. 5[55 4vD Text55$$If!vh5. 5[55 #v. #v[#v#v :V lX)5. 5[55 / / / 4K$$If!vh5X)#vX):V l X)5X)4D(Enter FIA Local Office Name$$If!vh5 555 #v #v#v#v :V lhX)5 555 / 4K$$If!vh5X)#vX):V lhX)5X)4K$$If!vh5X)#vX):V lhX)5X)4D- fiasignatureEnter Foster Care Worker's NameAddFIASignatureAuto$$If!vh5. 5[55 #v. #v[#v#v :V lX)5. 5[55 4vD Text55$$If!vh5. 5[55 #v. #v[#v#v :V lX)5. 5[55 / / / 4DText51@Enter Worker name, Typist initials, or other information desiredM$$If!vh5X)#vX):V l4X)5X)4f4G$$If!vh5X)#vX):V lX)5X)4G$$If!vh5X)#vX):V lX)5X)4$$If!vh5{5#v{#v:V l05{54ajDjDjD jDF8@8 g"Normal_HmH sH tH J@J Heading 1$$@&a$5CJOJQJT@T Heading 2$s@&]^s5CJOJQJDA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k(No List XOX User Input 10ptd8(CJOJQJkHLOL User Input 11ptd$ CJOJQJ\O\ User input 12ptd((5CJOJQJkHPO"P BLANKLINEdx5CJOJQJkHTO2T Captions 6ptd(CJ OJQJkHDO1BD Captions 6pt bold5`OR` Captions 6pt boxd<5CJ OJQJkHDO1bD Captions 6pt Nbox<DO1rD Captions 7pt dtCJDOqD Captions 7pt Bold5`O` Captions 7pt boxdt<5CJOJQJkH^O^ Captions 7pt NBoxdt<CJOJQJkHPOP Captions 8pt d`CJOJQJkH^O^ Captions 8pt Bold d`5CJOJQJkHFOF Captions 8pt box <DOD Captions 8pt NboxPPOP E Captions 9pt dLCJOJQJkHJOJ Captions 9pt Bold dLCJFOF Captions 9pt Box !dDO"D Captions 9pt Nbox"5PO2P Captions 10pt#d`( OJQJkHLO1BL Captions 10pt 2 line $<^OR^ Captions 10pt Bold%d8(5OJQJkHXObX Captions 10pt box&d`P OJQJkHHOQrH Captions 10pt Nbox'P5BOB Date 08pt(CJOJQJkH6O6 Date 09pt)CJ6O6 Date 10pt*CJ2O2 Date 11pt+CJJ @J Footer,dt !CJOJQJkHROR Form Title 10pt-$d8a$ OJQJkH^O^ Form Title 10pt Bld.$d8a$5OJQJkHVOV Form Title 11pt/$d$a$CJOJQJkHLOL Form Title 11pt Bld0d$CJVOV Form Title 12pt1$da$CJOJQJkHbO"b Form Title 12pt Bld2$da$5CJOJQJkH4@24 Header 3 !TOBT Letter Text 10pt4$d$a$ OJQJkHFOARF Letter Text 11pt5dCJXObX Letter Text 12pt6$da$CJOJQJkHHO!rH Small Blank Line 7CJ.)@. Page Number`O` CoSuppaddress9d8(OJQJ_HkHmH sH tH O c:VOV Address1;d8(OJQJ_HkHmH sH tH ZOZ CountyName<d8(OJQJ_HkHmH sH tH R@ Body Text Indent 2n=$ Snw I W*P X !$%`'w^w`a$CJ>'> Comment ReferenceCJFOFUser Input 09pt? mHnHuHOH User Input 07pt@< 5;CJ44  Comment TextA\O"\ EnteredCareBd8(5OJQJ_HmH sH tH H2H  Balloon TextCCJOJQJ^JaJ@j@ &Comment SubjectD5\XOQX aCaptions 9pt CharCJOJQJ_HmH sH tH   <  ( T w O|zJ3_"]/>""X####&$S$$$%%R&&V''((06@6:; =M==>>>@A|BBJ-]"S%ZǠ4lѡ6gȢ)YDxݤBsإ =q֦;lѧ6jϨ4eǩ,]ª'[%,@A]q)*+?STUeyz{|}~345AB "#7K_s1LMau.BTUVWs !"#$%)<=>D   : ; < A V W X Y     $ % & ' ( R S T U s t u v w  # $ % & ' * [  :!]LMNOz{|}~$8LMNOPQRSTUVWXYq&'S2vwxyzHIJKLOef/0123]^_`ad SJ !"#$%'GM[\] q-./0125Y<=>?@CT  !!&"'"""""""""""""""""######V#W#X#################$$$%$&$Q$R$S$T$U$V$Y$$$$$$$$$$$%%%%%%%%%%%%P&Q&R&}&~&&&&&&S'T'U'V''''''''''Q((((((((((((((()))) )!)")#)$)%)&)')())))))))))) **.*/*4*H*M*V*[***********+++#+<+=+C+]+b+r+v++++++++,,,]------------------------. .......&.+.3.9.A.B.C.K.R.S.T.U.V.`.i.j.k.l.q.{.........../$/6/J/K/_/q//////// 0 0 020D0X0l0000000000000000000000111s1t112S222334W4A5B56666>6?6@6a6b666777Q89::::;;;/;0;;;`<a<=== =K=L=M=m=n====>>>(>)>>>>>>>@@@@@AAATAUAVAfAgA{A|A}A~AAAAAAAAAAAAAAAAAAAAAAA B BBB B!B"B-B.B/B5B6BJBKB_B`BaBbBcByBzB{B|BBBEE_H`HJ0JEJSJTJUJWJXJZJ[J]J^J`JaJJJJJJ20 0 0 0 /0 0 0 0 /0 0 0 0 /0 0 0 0 /0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0!0 00 00 0 0 0 0 0 0 0 0 00 0!0 0 0 0 0 0 0 0 0 0 0 ?0 ?0 ?0 ?0 ?0 ?0 ?0 ?0 ?0 0 ?0 0 0 0 0 0 0 0 0 ?0 ?0 ?0 ?0 ?0 ?0 0 ?0 0 0 0 0 0 ?0 ?0 ?0 0 ?0 0 0 ?0 0 0 ?0 0 ?0 0 0 0 0 0 0 00 0 0 0 0 0 000000 0 0 0 0 0 0 000000 0 0 0 0 0 0 0 0 0 0!00!0 0 0 0 00 0 00000 0 00 0 00000 0 0 0 0000 0 00 0 0 0 0 00000 0 0 0 0 00000 0 0 0 0 00000 0 0 0 0 00000 0 0 0 0 0 00 0 0 0 00 0 0 0 0 0000 0 0 0 0 0 00 0 00000 0 0 0 0 0 00 0 00000 0 0 00 0 0 0 0  0 0 00!0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0!0 00000 0 0 00000 0 0 0 0 0 0 00 0 000000 0 0 00 00 0 000000 0 0 00 0 0 00 0 000000 0 0 00 0 0 0 0 00 0 000000 0 0 00 0 0 0 0 0 0 0 0 000!0 00000 0 0 0 00 0 0 00!0 00000 0 0 0 0 0 0 00!0 00000 0 0 0 0 0 00!0 00000 0 0 00 0 00000 0 0 0000 0 00000 0 0 00 0 0 0 0 "0 0 0 0 0 0 0 0 00000 0 0 0 0 0 00000 0 0 0 0 0 00000 0 0 0 0 0 00000 0 0 0 00!0 00000 0 0 0 00!0 00000 0 0%0%0%0 0 00000 00 0 0 0 0 00!0 000000 0 0 0 0 0 0 0 0 0 0 0 %0 0 0 0 0 0 0 00 0 ?0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 00 000!0 0000 00000 00000 00000 00000 0000 00000 000000 000000 000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0%0%0%0%0 0 %0 0 0000000000000 0 0000%0 0 =00000000%0 0 0000%0 0 00000%0 0 0000%0 0 %0 0 0000%0 0 %0 0 0000%0%0!0 000000 0 #0#0 00 0 0 0 #0#0 0 0#0 00 0 0 0 00 00 0 0 0 0 0 0 0 #0#0 00 0 0 0 #0#0 0 0#0 00 0 00 0 0 0 00 0 00000000 000 0 0@000@000@000@000@,0@0@,0@000,@A]q)*+?STUeyz{|}~345AB "#7K_s1LMau.BTVWs !"#$%)<=>D   : ; < A V W X Y     $ % & ' ( R S T U s t u v w  # $ % & ' * [  :!]LMNOz{|}~$8LMNOPQRSTUVWXYq&'S2vwxyzHIJKLOef/0123]^_`ad SJ !"#$%'GM[\] q-./0125Y<=>?@CT  !!&"'"""""""""""""""""######V#W#X#################$$$%$&$Q$R$S$T$U$V$Y$$$$$$$$$$$%%%%%%%%%%%%P&Q&R&}&~&&&&&&S'T'U'V''''''''''Q((((((((((((((()))) )!)")#)$)%)&)')())))))))))) **.*/*4*H*M*V*[***********+++#+<+=+C+]+b+r+v++++++++,,,]------------------------. .......&.+.3.9.A.B.C.K.R.S.T.U.V.`.i.j.k.l.q.{.........../$/6/J/K/000000000000000111s1t112S222334W4A5B56666>6?6@6a6b666777Q89::::;;;/;0;;;`<a<=== =K=L=M=m=n====>>>(>)>>>>>>>@@@@@AAATAUAVAfAgA{A|A}A~AAAAAAAAAAAAAAAAAAAAAAA B BBB B!B"B-B.B/B5B6BJBKB_B`BaBbBcByBzB{B|BBBEE_H`HJ0JEJSJTJJ00  00  00  @0 00  00 00 @0 00  0 0 0 0 @0 00  0 0 0 0 @0 00  00 00 @0 00  00 00 @0 00  00 00 @0 00  00 00 @0 00  0!0 0!0 0!0 @0 00 0&0 0&0 0&0 @0 00  00  00  00  00  0/0 @0 00 020  020 !@0 00  060  060  060  060  060  060  060  060  @0 00  0@0  0@0  0@0  0@0  0@0  0@0  0@0  0@0  @0 00  00  00  0L0  0L0  0L0  0L0  0L0  @0 00  0S0  0S0  0S0  0S0  0S0  @0 00  00  00 00 00  @0 0i0 0i0  0  0  0 0p0 0  0 0s0 0s0 0s0 0Dv  0  0  0  0  0 0|00|0 0 0  0 00 00 0 0  0 0 0 0 0 0 0 0 0  @0  0  0  0 0 0 0 0 0 0 0 0 0   0 0   0 0!00!`#|  0 0 000 #`#  0 0 0 00 0 00 0  000 00 0 0 0 0000 0  00 0 0 0 0  000 00 0 0 0 0  000 00 0 0 0 0  000 00 0 0 0 0  000 00 0 0 0 0 0 00 0 0 0 00 0 0 0 0 0000 0 0 0 0 0 00 0  000 00 0 0 0 0 0 00 0  000 00 0 0 00 0 0 0 0  0 0 00!0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0!0  000 00 0 0 00000 0 0 0 0 0 0 00 0 0 000 00 0 0 00 00 0 0 000 00 0 0 00 0 0 00 0 0 000 00 0 0 00 0 0 0 0 00 0 0 000 00 0 0 00 0 0 0 0 0 0 0 0 000!0  000 00 0 0 0 00 0 0 00!0  000 00 0 0 0 0 0 00!0  000 00 0 0 0 0 0 00!0  000 00 0 0 00 0 00000 0 0 0000 0  000 00 0 0 00 0 0 0 0 "0 0 0 0 0 0  0 0  000 00 0 0 0 0 0  000 00 0 0 0 0 0  000 00 0 0 0 0 0  000 00 0 0 0 00!0  000 00 0 0 0 00!0  000 00 0 0%0%0%0 0  000 00 00 0 0 0 0 00!0  000 000 0 0 0 0 0 0 0 0 0 0 0 %0 0 0 0 0 0 0 00 0 ?0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 00 000!0 0000 00000 00000 00000 00000 0000 00000 000000 000000 000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0%0 0%0%0 0 %0 0 0000000000000 0  000 0%0 0 =00000000%0 0  000 0%0 0 00000%0 0  000 0%0 0 %0 0  000 0%0 0 %0 0  000 0%0%0!0  0000 00 0 #0#0 00 0 0 0 #0#0 0 0#0 00 0 0 0 00 00 0 0 0 0 0 0 0 #0#0 00 0 0 0 #0#0 0 0#0 00 0 00 0 0 0 00 0  00000000 000 0  OOOOOOOOOOOOOOOOOOOOOOOO,8>q}!'?KQeqw#/57CIKW]_kqsMY_amsu&,.:@BRs  8  ( P w Ox"$068DJzF3[]+:""X####&$O$$$%%R&{&V''((................. ///"/$/4/6/B/H/K/W/]/_/o/q///////////////////0 0 000 00020B0D0P0V0X0d0j0l0x0~000000000006<6:: =I==>>>@ACAOARAgAsAyAAAAAAA BBB6BBBHBKBWB]B|BBJFFFFFFFFTFTFTFFFFFFFFFFFFFS$S$FFS FS$F3333333333FFFF333333333333333333FS$S$FFFFS$S$FFS S FFFFS S FFS S FFFFS S F333333FFFFtFFFt3CJL!T!8@0(  B S  ?FCWorkerLoadNo FCWorkerNamePOSAPOSWCofRCOJCDN ChildNameText33 Dropdown6ChildText11Text16 AddSignatures fiasignature-r@f$LBL/DAhA BJ ?(Rx6^S^/SAzABJc-Dec-T?ec-b c-l/] c-c c-/] c-<",J)y<0¸O|kLTS5Phx (VlMf)f|Oz?p~C<fPEhh^h`<B* OJQJo(phfhh^h`<B* OJQJo(phfhh^h`B* OJQJo(phfhh^h`<B* OJQJo(phfhh^h`<B* OJQJo(phfhh^h`<B* CJOJQJo(phfhh^h`<B* OJQJo(phfhh^h`B* CJOJQJo(phf!hh^h`<B* OJQJo(phfhH^`OJQJ^Jo(hHopp^p`OJQJo(hH@ @ ^@ `OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHhh^h`B* OJQJo(phfhh^h`B* OJQJo(phfhh^h`B* OJQJo(phfhh^h`<B* OJQJo(phfhh^h`<B* OJQJo(phfhh^h`B* OJQJo(phfOz ?$-p~ )y<' O|kL9>@9 (VlMf)ffPES5P^          @ihW$):\mH5o*:n ' J S W= F l  =u iaK Jfg`#|:[z[=Dv"N3q0Rr{e(y2 < g""!#C#T#Lw#I$ %7%Q' &'i;'q'G(\*=i*8-B-~c-&a.l/M0A1 K4G6t 8>78c8K9B]97L:D;gP;4<P.>>?(R?V?HW@KAaAmA36C`C!D-EIk1I5I`IbIsI|@J8"K&K+gKM;M?M3dNlNOaOfqOQRR}ZRtR SlSzKUOb d|df=GfZfVgh0iQij_j9krakx,lmvpFq8qrrx6rdrVuEuxu v 0vEzQzOL{_{q|(|~}d}j~S H%[rYC 3?pF2-ZF_#roacCDDKQ~?MPT~|Xd6N$-d'2 1WJ&y|E.^zLiUj l CRn/rh?qIDHoaxvD\u? eCDfJ~W^lmA7wR _=,x hqTl7`]9$G9:m5\(g &PS',jTtNDz(TYi|jrlUq |>c4X c&<&XfGa~\ 6YKeJO@e8}kszc> PaX31!LB|o:U,@A]q)*+?STUeyz{|}~345B "#7K_s1LMau.BTUVWs !"#$%)<=>D  : ; < A V W X   $ % & ' T U s t u v  $ % & ' * MNz{|}~$8LMNOPQRSTUVWXwxJKLO01_`ad !"#$%'[\./0125>?@C"""""""""""""######V#W###############$$$%$Q$S$T$U$V$Y$$$$$$$$$$%%%%%%%%%P&Q&}&~&&&&T'U''''''''((((((((((()))) )!)")#)$)%)&)')()))))))))) **.*/*4*H*M*V*[***********+++#+<+=+C+]+b+r+v+++++++------..A.T.k........./$/6/J/K/_/q//////// 0 0 020D0X0l0000000000000000000011s1t166>6?6@6a6b6::;;/;0;==M=m=n===>(>)>>>>@@ATAUAfA{A|A}A~AAAAAAAAAAAAAAAAA BBB B!B-B.B5BJBKB`BaBbBcBzB{BE_H`HJSJTJUJWJZJ]J`JJJUVVVVVVVVVVVVVVVVVVVqVVVjVVVVVVVVVVVVVVVVVVVVVVVVVVV VVV!VVV" VVV#VVV$ VVV%VVV& VVV'VVV(VVV)VVV* VVV+ VV D  ( Ado&be PDFCreateAdobePDF7.0Custom Popup 1561815 (Acrobat &CommentsImportComments6Custom Popup 1561825( Mail R&ecipient as Adobe PDFAdobeSendToMailAsPDF3,( ffzzzyyyffffffffffffffffffffffffffffff{{HHfffffffffflljjffffffffffPPffffffffffffffffffffffffffffff6/?~<z9c$a"]]]]11ǍJ]11ˑN]1111111111ϔQ^ ffҘTu5n.a"ff١\v6u5m-ffffffffffffffۣ^q0ffffffffffffffݥ`ݥ`ۣ_ʏLnjJ~={:x7t4p(@( Mail &Merge to Adobe PDFMail &Merge to Adobe PDFMail Merge to Adobe PDF80,( ffffffffffzzzyyyffffffLLLffffffffPPPPPPffTTTTTTTTTTTTTTT{{HHffYYYYYYYYYYYYYYYYYYlljjff]]]]]]]]]]]]]]]PPffffffbbbbbbfffffffffffffffНYȕQGv4k+a XP6/ffffԢ^TНYȕQGv4k+a XPYԢ^T`jj קcYe%ffff۫f`v4k*ffffffޮiv6e%ffffffffffffffffl۬g֦aȔQG>v4k*ffffffffffffffffp(@ FC PWSP Tools FC PWSP ToolsLf=0(Add Svc Ref RowAdd Svc Ref ButtonAddSvcRefButton.AddSvcRefButton(p( Add SvcRef HeadingSvc Ref HeadingSvcRefHeading.MAIN(p(;(RemoveSvcRefHeadingRemove Svc Ref Heading'RemoveSvcRefHeading.RemoveSvcRefHeading(p(FC PWSP Tools 2FC PWSP Tools 2Lf| Lf| Lf| Lf| Lf| 0 Change Case Info Case Info CaseInfo.MAIN(p(; Clear Case InfoClear Case InfoClearCaseInfo.MAIN(p(; Remove Table Row Remove RowRemoveRow.MAIN(p(;( Check SpellingCheckSpelling.CheckSpelling(p(( Tool Help ToolHelp.MAIN1Custom Popup 1561815 Custom Popup 15618150( &Convert to Adobe PDF(( ffffzzzyyyffffffffffff6ffffff( 9ffffff`Lxy~~ffffffXT/3tZZ?18ffffffEB\4ffffffSGveffffffw^sWffffffwmffff11ffff11ffffff11111111111111ffffffffffffffffffffffffffffffffffffffp(@?( Convert to Adobe PDF and &Email(( ffzzzyyyffffffffffffffffffffffffffffff{{HHfffffffffflljjffffffffffPPffffffffffffffffffffffffffffff6/?~<z9c$a"]]]]11ǍJ]11ˑN]1111111111ϔQ^ ffҘTu5n.a"ff١\v6u5m-ffffffffffffffۣ^q0ffffffffffffffݥ`ݥ`ۣ_ʏLnjJ~={:x7t4p(@( )Convert to Adobe PDF and Send for &Review(( ffzzzyyyffffffffffffffffffffffffffffff{{HHfffffffffflljjffffffffffPPffffffffffffffffffffffffffffff6/ffffffff11ffffffff11% meaff1111111111+ pff19ff39 ffffffffffffffGgdK<<* ffffffffffffffffcccccccffp(@(Change Conversion &Settings( Mail &Merge to Adobe PDF(( ffffffffffzzzyyyffffffLLLffffffffPPPPPPffTTTTTTTTTTTTTTT{{HHffYYYYYYYYYYYYYYYYYYlljjff]]]]]]]]]]]]]]]PPffffffbbbbbbfffffffffffffffНYȕQGv4k+a XP6/ffffԢ^TНYȕQGv4k+a XPYԢ^T`jj קcYe%ffff۫f`v4k*ffffffޮiv6e%ffffffffffffffffl۬g֦aȔQG>v4k*ffffffffffffffffp(@( Start Meetin&g(( gr`h"CNGPHQHQHQHQHSPffffffffffffQzbi-ttttnU^QffffffffffffgƛPzx.QffffffffffffpھȟӲ^co HQHQco nnnSSSffțs}1R^ R^ xGƜƜ̦̦̦CLLLffffq}.ofku5u+k_VV\\\ff:oȞǝǞĘyWҾnnnff:ˢˤřǜǝÖcm!qqqffEֵˤřƚǛĘ3zzzffHƘˤˤřo~ffffG̣oKffffffH99Y]]\YYYjjj|||yyyffffffffYYYffffffffwww||||||||||||ffffffffffffffffffffffffffffffffp(@???% 0z 1Custom Popup 1561825 Custom Popup 15618250( &Import Comments from Acrobat...( &Continue Integration Process...(&Accept All Changes in Document( &Delete All Comments in Document(&Reviewing ToolbarAdobeReviewingToolbar19(&Show Instructions...)1 6< Spell Check Spell Check2(LQ+2(LQ+2(LQ+2(LQ+2(LQ+0(  Spell CheckForms Spell Check2Module1.FormsSpellCheck2gTemplateProject.CaseInfo.MAIN(TemplateProject.NewMacros.AddChildInfoYN(TemplateProject.NewMacros.AddSignatureYN(TemplateProject.NewMacros.AddSvcRefRowYN+TemplateProject.CheckSpelling.CheckSpelling7TemplateProject.ServiceReferralAuto.ServiceReferralAuto-TemplateProject.NewMacros.AddYouthSignatureYN!TemplateProject.PopUpPrompt3.MAIN'TemplateProject.AddChildRow.AddChildRow;TemplateProject.AddYouthSignatureAuto.AddYouthSignatureAuto1TemplateProject.AddSignatureAuto.AddSignatureAuto/TemplateProject.AddSvcRefButton.AddSvcRefButton3TemplateProject.RemoveSvcRefHeading.InsertSvcRefRow9TemplateProject.AddIdentandLegalAuto.AddIdentandLegalAuto7TemplateProject.RemoveSvcRefHeading.RemoveSvcRefHeading2TemplateProject.AddIndentInfoAuto.AddIdentInfoAuto+TemplateProject.NewMacros.AddYouthSignature)TemplateProject.NewMacros.PromptNameTitle,TemplateProject.NewMacros.AddParentSignature/TemplateProject.NewMacros.AddNameTitleSignature'TemplateProject.NewMacros.AddParentRowsTemplateProject.NewMacros.MAIN!TemplateProject.PopUpPrompt2.MAIN7TemplateProject.AddFIASignatureAuto.AddFIASignatureAuto"TemplateProject.SvcRefHeading.MAIN"TemplateProject.ClearCaseInfo.MAINTemplateProject.RemoveRow.MAINTemplateProject.ToolHelp.MAINTEMPLATEPROJECT.CASEINFO.MAINTEMPLATEPROJECT.TOOLHELP.MAINTEMPLATEPROJECT.NEWMACROS.MAINTEMPLATEPROJECT.REMOVEROW.MAIN!TEMPLATEPROJECT.POPUPPROMPT2.MAIN!TEMPLATEPROJECT.POPUPPROMPT3.MAIN"TEMPLATEPROJECT.CLEARCASEINFO.MAIN"TEMPLATEPROJECT.SVCREFHEADING.MAIN'TEMPLATEPROJECT.ADDCHILDROW.ADDCHILDROW'TEMPLATEPROJECT.NEWMACROS.ADDPARENTROWS(TEMPLATEPROJECT.NEWMACROS.ADDCHILDINFOYN(TEMPLATEPROJECT.NEWMACROS.ADDSIGNATUREYN(TEMPLATEPROJECT.NEWMACROS.ADDSVCREFROWYN)TEMPLATEPROJECT.NEWMACROS.PROMPTNAMETITLE+TEMPLATEPROJECT.CHECKSPELLING.CHECKSPELLING+TEMPLATEPROJECT.NEWMACROS.ADDYOUTHSIGNATURE ,TEMPLATEPROJECT.NEWMACROS.ADDPARENTSIGNATURE!-TEMPLATEPROJECT.NEWMACROS.ADDYOUTHSIGNATUREYN"/TEMPLATEPROJECT.ADDSVCREFBUTTON.ADDSVCREFBUTTON#/TEMPLATEPROJECT.NEWMACROS.ADDNAMETITLESIGNATURE$1TEMPLATEPROJECT.ADDSIGNATUREAUTO.ADDSIGNATUREAUTO%2TEMPLATEPROJECT.ADDINDENTINFOAUTO.ADDIDENTINFOAUTO&3TEMPLATEPROJECT.REMOVESVCREFHEADING.INSERTSVCREFROW'7TEMPLATEPROJECT.ADDFIASIGNATUREAUTO.ADDFIASIGNATUREAUTO(7TEMPLATEPROJECT.REMOVESVCREFHEADING.REMOVESVCREFHEADING)7TEMPLATEPROJECT.SERVICEREFERRALAUTO.SERVICEREFERRALAUTO*9TEMPLATEPROJECT.ADDIDENTANDLEGALAUTO.ADDIDENTANDLEGALAUTO+;TEMPLATEPROJECT.ADDYOUTHSIGNATUREAUTO.ADDYOUTHSIGNATUREAUTO@9>m99  ./01PAJ`` `@````(@` `D@`>`@`B`@`nUnknownGz Times New Roman5Symbol3& z Arial?5 z Courier New5& zaTahoma;Wingdings"h8&C&C&Pq >ex >exr c#4dGG]/ 2QHX? 1*<DHS-0068A, Treatment Foster Care Permanent Ward Service PlancompDepartment of Human ServicesH          9Oh+'00 Xd    @DHS-0068A, Treatment Foster Care Permanent Ward Service Plancomp 0068-a.dot Department of Human Services80Microsoft Office Word@w3@R@]N@R >՜.+,04 hp  State Of MichiganxeG' =DHS-0068A, Treatment Foster Care Permanent Ward Service Plan Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~     ? !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~jvRoot Entry F-`Data 1TableWordDocument*2SummaryInformation(DocumentSummaryInformation8Macros)'03`0 `VBA03`0 `dir__SRP_0 >__SRP_1__SRP_2   "#$%&'()*+,.0123456789:<>?@ABCDEFGHIJKLMNOPQRSTUVWXZ\]^_`abcdefghijklmnpqrstuvwxyz{|}~0* pHdTemplateProjectQH@  = | j LH J< 9stdole>stdoleP h%^*\G{00020430-C 0046}#2.0#0#C:\WINDOWS\system32\e2.tlb#OLE Automation0MSForms>SFFrms3ED452EE1-E08F-101A-8-02608C4D0BB4EFM20.DLL#Microsoft : ^ Ob Library/;D~1u00}#0#k0 B93EC931- 5114-95-8D97-22894C6A06CF6DOCUME~1\bushd2\LOCALS\VBE\Tp.exd;@!.E .`M AOfficODf@ic 12DF8D04C-5BFAgB-BDE5IAA421gram Files\Comm onhShared\o 11\mso.dll4& 8.0p@%"»ThisDocumentG T@iDcuen@* 2  HB15B,!"E"+ToolHelpG\qH,lpj2roDu o! e RemoveRowGmvRw2/Ѱ ,@Serv`LReferrablG&`rv#NRf"raA@5t R<2 ')'!@,Svc HeadingG%`Y`c8aim@JgN2\/ 0* ClearCaseInf o#C¼arC`(s)If(oN#W/]N|oNNewMaEcNNwM c o@qaNcN/@->+!n"!n!i#nmoT|,/FZAddIdGandhLeg/("d,IPHad*Lgl*Ss2tn0? Pxe\/1;SC/1;Q/CS0" \ BQheckSpellU^C epkpmlpU^C)uThـc/   "q,ChilZd{ i d0ho|2m{)InMf35{0qfd5g0f2o 9  AQPopUpm(pt3P3pUPPhmtȯp73? }?1? 8z2? r 3 Q%< 27? Pv}; qq:R &oRgt0R/V -_(; rU    -View instructions for using FIA-#### buttons. !TemplateProject.PopUpPrompt2.MAIN]rU $     5j !"#$%&'()*+,-./01234u789:;<=>?ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghikwmnopqrstxyz{|}K*y  rU~~~~~~~~~~~~~~~~P 4oxIwLGޫh]   !Qya 1  Iya 1 0a 1 H!Qa 1  y  ThisDocumentToolHelp RemoveRowServiceReferralAuto SvcRefHeading ClearCaseInfo NewMacrosCaseInfoAddIdentandLegalAutoRemoveSvcRefHeadingAddFIASignatureAutoAddYouthSignatureAutoAddSvcRefButton CheckSpelling AddChildRowAddIndentInfoAuto PopUpPrompt3 PopUpPrompt2AddSignatureAutoTemplateProjectVBAF@C:\Program Files\Common Files\Microsoft Shared\VBA\VBA6\vbe6.dll  10 F5C:\Program Files\Microsoft Office\OFFICE11\MSWORD.OLBWord A@0FC:\WINDOWS\system32\stdole2.tlbstdole )QP.E .`M C:\WINDOWS\system32\FM20.DLLMSForms  1y`1> Q%E"Lj 0C:\DOCUME~1\bushd2\LOCALS~1\Temp\VBE\MSForms.exd  1ypL-[DR?C:\Program Files\Common Files\Microsoft Shared\office11\mso.dllOffice ! MAIN  ZYou MUST Save This Document Before Continuing 2Select Save In Folder andBeginDialog YourFCWLNo HEnter File Name in SaveAs Dialog Box F F ColorButtonsLargeButtonsToolTipsViewToolbars BordersToolbarHide Database Drawing Formsp Fb F Fk F CaseInfoTextBox YourFCWN YourPOSA YourPOSW YourCOFR YourCOJ YourCDN YourDC `Enter the following information about this case.Text .DHS FC Worker Load No.: &DHS FC Worker Name: POS Agency Name: POS Worker Name: &County of Referral: &Court Jurisdiction: "Court Docket No.: Date Completed:OKButtonCancelButtonEndDialogCurValuesUserDialog UserInfo FCWorkerLoadNo c:\caseinfo.ini FCworkerLoadNo 0GetPrivateProfileString$YourFCWLNo FCWorkerNameYourFCWN POSAYourPOSA POSWYourPOSW CofRYourCofR COJYourCOJ CDNYourCDN DCompleted YourDC Dialog .SetPrivateProfileStringAddIdentInfoAuto FCWORKERLOADNO  ExistingBookmark FCWorkerLOADNoSetFormResult FCWORKERNAME DCOMPLETEDfĤIx8< Error In Case InfoVBE6.DLL Y`  Y YS  0Add Service Referral Row d**To Add Additional Row(s) for Service Referrals** @After entering Completion Date,  NClick ADD SVC REF ROW Button on Toolbar cladd87u F AddServiceRefAutoTextEntries WhereRichText Insert lThere is already ONE Identifying Information section.  VHow many ADDITIONAL IDENTIFYING INFORMATION t for Child(ren) groups are needed for this report? h Example: {Total children being reported = 3} # { Minus existing = 1}# { Enter additional = 2} *CANCEL or ESC if none .IDENTIFYING INFORMATION 0 addidentinfo ChildName  YT `qrU~| PQ y  ) i Iq!Iq 1iAqy i a!y9i  Y1Y 9Y 1Y Y9qdK:, < <   :    :|`1x6< |6(,%(%(T%t$ @t  t.:, %(%t$ @t t.:,%(%t$ @t t.:,%(%t$ @t t.:,%(%t$ @t tt$ t tt$ 8Qt@ @ t@ Qt< < c<c@t$ 4t t.(,I%(^%:T%t$ @tt:(,%( %(T,%(,%: %t$ @tt:(,%(8%(T,%(,%: %t$ @tt:(,%(P%(T,%(,%: %t$ @tt:(,%(h%(T,%(,%: %t$ @tt:(,%(%(T,%(,%: %t$ @tt:(,%(%(T,%(,%: %t$ @tt:(,%(%(T,%(,%: %t$ @tt:(,%(%(T,%(,%: %t$ @tt:(,k%( %(T%(, %: %t$ @t!t:(,%($%(T%(, %: "%t$ @t!t:(,%(;%(T%(, %: #%t$ @t!t:(,%(S%(T%(, %: $%t$ @t!t:(,%(k%(T%(, %: %%t$ @t!t:(,%(%(T%(, %: &%t$ @t!t:(,%(%(T%(, %: '%t$ @t!t:(,%(%(T%(, %: (%t$ @t!t:(,%(%(TT%(, %: )%t$ @t!t4(,^%(%(TX%(,%t$ @t*t4(,%(%(TX%(,%t$ @t+tKt$ @t,t.t$ @tW<-A.4t6<C:,/%:,0%:1%:T2%t$ @t<%3t5<C:,/%:,0%:4%:T2%t$ @t<%5t5<C:,/%:,0%:6%:T2%t$ @t<%7t5<C:,/%:,0%:8%:T2%t$ @t<%9t5<C:,/%:,0%::%:T2%t$ @t<%;t5<C:,/%:,0%:<%:T2%t$ @t<%=t5<C:,/%:,0%:>%:T2%t$ @t<%?t5<C:,/%:,0%:@%:T2%t$ @t<%At5<1 @t$ @tW%W%:T2%t$ @t<`1Pt5<?:,/%:,0%:@%:T2%t$ @t<`1Lt5<,:,E%t$ @t%t$ @t%P@t$ @tHt,:,J%t$ @tF< M2)t6<  dX@ @<L`\dhPlTXxHt< |k__SRP_3g__SRP_4 !__SRP_5-o__SRP_6 /`nrU~|   ya!!9i1$.(XF%(8p%:%h$ @hh:(X %(8 %(%( %:%h$ @hh:(X;%(8 %(%( %:%h$ @hh:(X;%(80%(%( %:%h$ @hh4(X^%(8R%(N%(%h$ @h h4(X%(8R%(X%(%h$ @h hh$ @h h.h$ @hW A 4h61 @h$ @hWB lh5l(X]3,lhkrU $`anrU~|   ""!#I####x$ 4x x):hNXXx$ 4x x5X7'(8Xx$ <x x6X8x$ <x \xx$ x |xox$ <x Qo8%c%:h%X $ 4 XX>  )x 6X82(8Xx$ <x x6X87'(8Xx$ <x x6X8?'':hNXXc8x$ 4x Hx6X8$ (x X8krU $`nrU~|  y* $$%& ())I* ,Q  !+ __SRP_7;g__SRP_8=__SRP_9YgCaseInfo7 ""!9+I####+qK l        |  <     '' ','L(l:N:\lL:<, ::|l:\L<,: : F68lL, |lL<, lL, :\ l lL , ,:<    : `16lL, 3:\ ]3$ 4 ):\Nll$ 4 5l(<(\p7',(L l$ < 6lL,$ < \$  |o|$ < Q|oL%c%:\%lx$ 4x Xl>)x6lL2(Ll$ < 6lLF|:<NLL'',l$ < )|6lL, V?'',:\NllcL$ 4 H6lL,$  lfV&','L'lM\@ 6lL, mt  , || '',l#p*#l*FL0>tFl 2pl)|6lL, <$#tpl|xlL, |lL<, lL, @krU $`nxME v,|xME@6 ? b dx `6?@6?x6?6?6? <?X " d f(BU>U d f `.UH.Ux.U.U.U:U8 4x  &$&. 8mP6   ]@Dim UserFCCNo$es N Dim UserFCCN$@]X]pDim UserPSCNo$m Dim UserPSCN$] Dim UserCTNO$"]] Dim UserHAL$ Dim UserHAF$]]]]H-You MUST Save This Document Before Continuing $N $N Select Save In Folder and $N $N $Enter File Name in SaveAs Dialog Box ' P Define prompt$EnOPEN FCISP TOOLSs "$& B@ en texBorders( B@ VDatabase( B@ NE DIADrawing( B@ ,Forms( B@ display hidden text  l(  Your "9$59&qq VB@Xsave document'DEFINE DIALOG BOXI^CaseInfo B@,ur1 WordBasic.TextBox 150, 32, 300, 18, "YourFCWLNo" , YourFCWLNo B@(/ WordBasic.TextBox 150, 56, 300, 18, "YourFCWN"8,YourFCWN B@(P,YourPOSA B@( h,YourPOSW B@(ou,YourCOFR B@(ic,YourCOJ B@(Lo,YourCDN B@(ke,YourDC B@(asick  0Enter the following information about this case. B@dke: WordBasic.Text 19, 36, 130, 13, "DHS FC Worker Load No.:"$ DHS FC Worker Load No.: B@d6 WordBasic.Text 19, 59, 130, 13, "DHS FC Worker Name:"0; DHS FC Worker Name: B@d(S POS Agency Name: B@dk POS Worker Name: B@d County of Referral: B@d Court Jurisdiction: B@d.2fo Court Docket No.: B@dT Date Completed: B@dWo^X B@.StringX B@  "c:\c0 B@0h]F !4!6.2.[6GET USER INFO FROM INI FILE AND PUT IT INTO DIALOG BOXinfogdlgUserInfo.YourFCCNo = WordBasic.[GetPrivateProfileString$]("UserInfo", "FCCaseNo", "c:\caseinfo.ini")hdlgUserInfo.YourFCCN = WordBasic.[GetPrivateProfileString$]("UserInfo", "FCCaseName", "c:\caseinfo.ini")erUserInfoFCWorkerLoadNoc:\caseinfo.ini %, 2(* WorUserInfo FCWorkerNamec:\caseinfo.ini %, 2(.seinfogdlgUserInfo.YourPSCNo = WordBasic.[GetPrivateProfileString$]("UserInfo", "PSCaseNo", "c:\caseinfo.ini")inhdlgUserInfo.YourPSCN = WordBasic.[GetPrivateProfileString$]("UserInfo", "PSCaseName", "c:\caseinfo.ini")iedlgUserInfo.YourCTNO = WordBasic.[GetPrivateProfileString$]("UserInfo", "COURTNO", "c:\caseinfo.ini")UserInfoPOSAc:\caseinfo.ini %, 2(0NUserInfoPOSWc:\caseinfo.ini %, 2(2ompletUserInfoCofRc:\caseinfo.ini %, 2(4OG BOXUserInfoCOJc:\caseinfo.ini %, 2(6UserInfoCDNc:\caseinfo.ini %, 2(8ILEUserInfo DCompletedc:\caseinfo.ini %, 2(:,DISPLAY DIALOG BOX AND RESPOND TO USER INPUTBasic. 2 !8%6'g  OK BUTTONseWRITE NEW USER INFO IN INI FILEbWordBasic.SetPrivateProfileString "UserInfo", "FCCaseNo", dlgUserInfo.YourFCCNo, "c:\caseinfo.ini"cWordBasic.SetPrivateProfileString "UserInfo", "FCCaseName", dlgUserInfo.YourFCCN, "c:\caseinfo.ini"gUserIUserInfoFCWorkerLoadNo 2!*c:\caseinfo.ini B@<ing UserInfo FCWorkerName 2!.c:\caseinfo.ini B@<hbWordBasic.SetPrivateProfileString "UserInfo", "PSCaseNo", dlgUserInfo.YourPSCNo, "c:\caseinfo.ini"bWordBasic.SetPrivateProfileString "UserInfo", "PSCaseNo", dlgUserInfo.YourPSCNo, "c:\caseinfo.ini"cWordBasic.SetPrivateProfileString "UserInfo", "PSCaseName", dlgUserInfo.YourPSCN, "c:\caseinfo.ini"o.ini`WordBasic.SetPrivateProfileString "UserInfo", "COURTNO", dlgUserInfo.YourCTNO, "c:\caseinfo.ini"2UserInfoPOSA 2!0c:\caseinfo.ini B@<N 2UserInfoPOSW 2!2c:\caseinfo.ini B@<ompletUserInfoCofR 2!4c:\caseinfo.ini B@<o fromUserInfoCOJ 2!6c:\caseinfo.ini B@<ofileSUserInfoCDN 2!8c:\caseinfo.ini B@<`UserInfo DCompleted 2!:c:\caseinfo.ini B@<Get user info from INI file8\UserFCCNo$ = WordBasic.[GetPrivateProfileString$]("UserInfo", "FCCaseNo", "c:\caseinfo.ini")o.ini]UserFCCN$ = WordBasic.[GetPrivateProfileString$]("UserInfo", "FCCaseName", "c:\caseinfo.ini")caseUserInfoFCworkerLoadNoc:\caseinfo.ini %,' UserInfo FCWorkerNamec:\caseinfo.ini %,' \UserPSCNo$ = WordBasic.[GetPrivateProfileString$]("UserInfo", "PSCaseNo", "c:\caseinfo.ini")fo]UserPSCN$ = WordBasic.[GetPrivateProfileString$]("UserInfo", "PSCaseName", "c:\caseinfo.ini")0ZUserCTNO$ = WordBasic.[GetPrivateProfileString$]("UserInfo", "COURTNO", "c:\caseinfo.ini")UserInfoPOSAc:\caseinfo.ini %,' ,UserInfoPOSWc:\caseinfo.ini %,'  UserInfoCofRc:\caseinfo.ini %,' UserInfoCOJc:\caseinfo.ini %,' orUserInfoCDNc:\caseinfo.ini %,' UserInfo DCompletedc:\caseinfo.ini %,' Form Update Form with user info@]If WordBasic.ExistingBookmark("FCCASENO") Then WordBasic.SetFormResult "FCCASENO", UserFCCNo$WORK`If WordBasic.ExistingBookmark("FCCASENAME") Then WordBasic.SetFormResult "FCCASENAME", UserFCCN$PSFCWORKERLOADNO %>GFCWorkerLOADNo  B@@jENAME" FCWORKERNAME %>G FCWORKERNAME  B@@j]If WordBasic.ExistingBookmark("PSCASENO") Then WordBasic.SetFormResult "PSCASENO", UserPSCNo$%>`If WordBasic.ExistingBookmark("PSCASENAME") Then WordBasic.SetFormResult "PSCASENAME", UserPSCN$ZIf WordBasic.ExistingBookmark("COURTNO") Then WordBasic.SetFormResult "COURTNO", UserCTNO$POSA %>GPOSA  B@@jPOSW %>GPOSW  B@@jCofR %>GCofR  B@@jCOJ %>GCOJ  B@@jCDN %>GCDN  B@@j DCOMPLETED %>G DCOMPLETED  B@@j0. Update other Form Fields on Form & Exit Macro0d8k0(| H P A@d fsave file cancelledse #return to point of error in routine32 ! Error ! In Case InfoA@+Reprotect Document and exit sub after errorurko@6WordBasic.ViewToolbars Toolbar:="FCISP Tools", Show:=1)Attribute VB_Name = "CaseInfo" Public Sub MAIN() Dim iRet '(UserFCC8No$ >WL@ N ^PS @a CTNO?PhOSA WH4AL F;CofR OJDK DC On Error GoTo Hand lerompt$You MUST Save This Document Before Continuing" + Chr(10)"Select!In Folder :EntFileR inA?ialog Box'Define pY^'OPEN FCISP TOOLS WordBasic.ViewToo lbars@.lorButtons:=1, LarDge0, T