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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

3-15-2018

Subchapter:

1

Forms

Issuance:

26.92

CP&P Form 26-92, Department of Children and Families Consent to be Photographed, Identified and/or Interviewed

 

Click here to view or print the CP&P Form 26-92.

 

Click here to view or print the CP&P Form 26-92(S).

 

PURPOSE AND USE

 

The Consent to be Photographed, Identified and/or Interviewed is used to obtain the consent of a CP&P client age 18 or over to be photographed, interviewed or identified by the press, film or television.

 

INSTRUCTIONS FOR COMPLETING THE FORM

 

Print the form from the manual. The client indicates his or her consent or no consent by circling the desired category as listed on the form. The client signs and dates the form and the Worker signs as the witness and indicates the name of the Local Office.

 

DISTRIBUTION

 

Original          -     

Child’s case record

Copy             - 

Child (age 18 or over)

Copy             - 

Residential center, if appropriate