Non-agency custody placement change details

Child Name

Select the name of the child whose placement information has changed. This list displays all child case members who are participants in this review. This field is required.

From Placement

Select the provider from whose care the child was moved. This field is required.

To Placement

Enter the full name of the non-agency provider with whom the child was placed. You can enter up to 50 characters.

Date of Change

Enter the date the child was placed with the non-agency provider. Use the format MM/DD/YYYY.  This field is required.

Additional Comments

Enter any additional information about this placement. You can enter up to 250 characters.