This questionnaire was designed as a way for you to inform the Judge handling your case of your specific situation. The information you provide is strictly voluntary. The more details you share, the better the Judge is able to make the best decision in your case. However, you do not have to answer every question.

 

Under current law, the Judge, your mother and/or father, Guardian Ad Litem, caseworker and the county attorney are allowed to view your answers.

 

The Judge handling your case may ask questions regarding the information you provide. 

General Information

Current Situation

Do you feel safe where you are living?
Do you feel comfortable where you are living?
If you are not living together, do you get quality time with your siblings?
Are your needs being met (getting enough to eat, having enough clothing, proper hair care items, etc?)
Do you have any concerns about your dental, vision, physical, or mental health that you want the Judge to know about?
Are you in counseling/therapy?
If you are attending therapy, is it helpful?
Do you have feelings or issues you need help explaining or understanding?
Do you take medicine?
If yes, do you feel it is helping you?
Are you participating in activities at school or elsewhere (sports, band, art club, dance, etc.)?
Do you currently have a job?

Case Information

Which of these people/groups have you seen or talked to in the last month:
Is there someone you’re not talking to who you want to be?

Team Meeting

A Team Meeting is a gathering of professionals, family, and your advocates to discuss your court case, progress, and any concerns or setbacks.

Do you attend your team meetings?
Do you feel comfortable speaking at team meetings?
Do you feel your concerns are being addressed?
Do you feel your team has your best interests in mind?

Case Plan/Court Report

A Case Plan/Court Report is a document that your DHHS caseworker makes and updates for most court hearings. It includes the services provided to you and your family and goes over what has happened since the last hearing.

Has someone reviewed the Case Plan/Court Report with you?
Do you have questions or concerns about your case plan?

GAL Report 

A GAL Report is a document written by the Guardian ad Litem, who is an attorney representing you and your best interests, to update the court on your case and provide the Judge with your perspective, wants, and needs.

Has your GAL reviewed their recommendations with you?
Do you have questions or concerns about your GAL’s recommendations?

Court Hearing

In a Court Hearing, the Judge is given information and updates on your family, which helps the Judge make decisions about your safety and the things you need

Have you been to a court hearing before?
Has your GAL talked with you about the different ways you can participate in your court hearings?
How would you prefer to participate in your court hearings?
Is there anyone you want attending your next court hearing with you?

Court Order

A Court Order is a written order from the Judge after the court hearing.

Do you receive copies of your court orders?
Do you want to receive a copy of your court order?

Independent Living Plan

An Independent Living Plan is a written plan to prepare you for living on your own once you have left foster care. The plan may include goals for completing education, finding a job, finding affordable housing, managing your money, etc. If you are over 14, you should have a plan. 

Do you have an Independent Living Transition Plan?
Have you been involved in creating the plan?
Do you feel secure with your transition plan?
Do you have a Driver’s license?
If no, do you need help getting one?

Personal Concerns/Goals

Do you want more information on careers/college/trades?