Relative Foster Care Placement Agreement

Child(ren) Name(s): Date of Birth:

Relative Foster Parent(s) Name(s): Relationship to Child(ren): Address: Phone Number:

Caseworker Name: Agency/Department: Contact Information:

Placement Agreement Terms

Expectations	Details
Care and Supervision
Medical and Educational Decisions
Communication With Agency
Visitation Arrangements
Financial Support
Terms of Placement

Signatures

Relative Foster Parent(s) Signature: Date: Caseworker Signature: Date: