DePaul Community Resources
Open Menu
Close Menu
About
Employment
Contact Us
Donate
Connect With Us
open-modal
DePaul Community Resources
Foster Care
Foster Care
Become a Foster Parent
Kinship Care
Resources
FAQs
Referrals
Counseling Services
Counseling Services
Outpatient Counseling Services
Home-Based Services
Intensive Care Coordination
Telepsychiatry Services
Crisis Services
Therapeutic Mentoring
Sponsored Residential
Sponsored Residential
Become a Sponsored Residential Provider
Resources
FAQs
Referrals
More Services
Adoption
Pre-Adoption Services
Post-Adoption Services
Referrals
Resources
FAQs
Independent Living
Support
Options
Referrals
Links
Submit Search
Post-Adoption Services Referral
Today's Date
*
Month
Day
Year
Name of family referred for services
*
First
Last
Parent 1
*
First
Last
Parent 1 Date of Birth
MM slash DD slash YYYY
Parent 1 Ethnicity
Select one
Select One
Hispanic/Latino
Non-Hispanic/Latino
Multi-Race/Multi-Ethnicity
Prefer not to say
Parent 1 Race
Select one
Select one
White, Hispanic
White, Non-Hispanic
Black or African American
American Indian or Alaskan Native
Asian
Native Hawaiian or Pacific Islander
Multi-racial
Unknown
Parent 2
First
Last
Parent 2 Date of Birth
MM slash DD slash YYYY
Parent 2 Ethnicity
Select one
Select one
Hispanic/Latino
Non-Hispanic/Latino
Multi-Race/Multi-Ethnicity
Prefer not to say
Parent 2 Race
Select one
White, Hispanic
White, Non-Hispanic
Black or African American
American Indian or Alaskan Native
Asian
Native Hawaiian or Pacific Islander
Multi-racial
Unknown
Primary phone number
*
Secondary Phone Number
Primary email
*
Secondary email
Physical Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Mailing address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
County
*
Adoption Information
Marital status
Parent(s) race(s)
Child information
Child's name*
DOB*
Gender Identity (i.e. Male, Female, Transgender, Non-Binary)
Relationship (i.e. Adopted child, biological, foster child, other)*
Race/Ethnicity
You have the ability to add up to 5 rows in this chart. Click the "+" sign on the right to add a new information row. Please contact us if you will need any additions. Please note that columns with * are required.
Does the family referred have a legal, finalized adoption?
*
Yes
No
Type of adoption (check all that apply)
*
Foster Care
Domestic
International
Reason for Referral
Please provide a brief description of why you are referring the family to post-adoption services and list any current family needs
*
(i.e.: training/education, peer support, family events, behavioral challenges, birth family connections)
Please list any current services accessed by family
Person Completing Referral Form
First Name
*
Last Name
*
Providing your first and last name above represents your digital signature for this form.
Phone number
*
Email address
*
Organization
CAPTCHA
Date
MM slash DD slash YYYY
Date
MM slash DD slash YYYY
close
Our Services
Foster Care
Adoption Care
Sponsored Residential
Community-Based Services
Independent Living
Day Support
The Garage
Volunteer
Submit Search