Therapeutic Foster Care Parent Application

Foster Care is temporary care for children who have the ultimate goal of  family reunification. This is a continuation of services provided by Heartfelt Alternatives with the same goal.  According to Wake. Gov,  "Foster parents play a vital role in understanding the needs of the children during these difficult times, and their help, intervention and nurturing can make all the difference to a child in need."
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Are you willing to attend initial and ongoing training? *
Has your family been licensed to do foster care before? *
Has your family applied to do foster care before? *
Our Family: Owns Rents *
Our family lives in: *
I give my consent and authorization to Heartfelt Alternatives, Inc. to request, receive and share information and professional records(Medical, Educational, Psychological, social, Department of Social Services and Court) about myself and others living in my home, with various agencies and professional facilities, public or private, in order to learn about my history with my family, children and the community. I understand and agree to the application process, including interviews with my neighbors, and references.

CONFIDENTIALITY AGREEMENT

 of Heartfelt Alternatives, Inc. acknowledge that policies related to confidentiality have been provide and explained to me. I understan that infromation about clients and their families will be shared with me for the purpose of providing foster care services. I also understand that this information is shared with others only when there is a need to know and when there is a written working agreement between agencies, or a specific signed release for information has been executed. I also understan that  this information cannor be shared with individuals and /or agencies that have no direct need for the information. I further understand that my employment/relationship can be terminated if I voilate the agency's confidentiality police. Inderstand and I am willing to comply with these confidentiality requirements.
Employee/Foster Parent/Volunteer *
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Employee/Foster Parent/Volunteer *
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Executive Director or Designee *
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