This form is to be completed by those who have the primary responsibility for the raising of the child (the adults who are around the child in the home the most). This could be the birth mother, the adopted mother, the two birth parents, the 2 adoptive parents, primary caregiver and fiancée, grandmother and grandfather, the grandmother and the mother, etc. A form must be filled out on each primary caregiver and submitted. It is acceptable for one caregiver to fill out the form for the other and submit for them.
Example: Two caregivers equals two forms. One form per caregiver.
The treatment plan cannot be written until all caregiver forms are summitted.
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Boo Boo, Co-Therapist
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