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NJ DCF Logo with reverse copy

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective

Date:

Volume:

X

Forms

Chapter:

A

Forms

8-22-2007

Forms

1

Forms

Issuance:

14.86g

CP& Form 14-86g, Acknowledgement of Counseling Received

 

 

Click here to view or print the CP&P Form 14-86g, Acknowledgement of Counseling Received.

 

WHEN TO USE IT

 

The Acknowledgement of Counseling Received, CP&P Form 14-86g, is used by CP&P to document the parent's receipt of counseling or waiver of the right to receive counseling concerning the surrender of his or her child.

 

HOW TO USE IT

 

•           Access it through the Create > Casework > Court/Legal > Options Drop-down.

 

•           Only complete this template outside of the NJ Spirit application as part of a contingency plan when the application is unavailable.  However, in doing so, you are still required to create the form in NJ Spirit when the application becomes available.

 

•           Print the form for approval and signatures, as explained.

 

TIPS FOR COMPLETING THE FORM

 

CP&P Form 14-86g is a template generated by NJ SPIRIT.  The Worker enters the name of the child, on-line, in the NJ SPIRIT application, and prints a copy of  CP&P Form 14-86g.  If more than one parent is present, the Worker prints an additional copy of CP&P Form 14-86g, to accommodate the other parent's signature. If the parent is surrendering more than one child, complete a separate form for each child.

 

The Worker instructs the parent to check the appropriate checkbox on the form, to indicate whether he or she has received face-to-face counseling sessions or waives the right to counseling.  After selecting a checkbox, the parent signs and dates the form in the space provided.

 

The Worker signs his or her name as witness to the parent's signing.

 

DISTRIBUTION

 

Original                      -           Court

 

Copy                           -           Case Record

 

Copy                           -           Parent

 

Electronic copy         -           NJ SPIRIT Electronic Case Record