Form DCF-159 "Immediate Removal / 96-hour Hold of Children" - Connecticut

What Is Form DCF-159?

This is a legal form that was released by the Connecticut State Department of Children and Families - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2016;
  • The latest edition provided by the Connecticut State Department of Children and Families;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DCF-159 by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Children and Families.

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Download Form DCF-159 "Immediate Removal / 96-hour Hold of Children" - Connecticut

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Department of Children and Families
IMMEDIATE REMOVAL / 96-HOUR HOLD OF CHILDREN
DCF-159
3/16 (Rev.)
Page 1 of 2
TO: Name of Parent(s) or Guardian(s):
Address: (No. and Street)
City
State
Zip
RE:
Name of Child:
DOB:
Name of Child:
DOB:
Name of Child:
DOB:
Name of Child:
DOB:
Name of Child:
DOB:
This is to advise you that, pursuant to Connecticut General Statutes §17a-101g, a duly authorized agent for the Commissioner of Children and Families
has determined that the immediate removal of your child(ren) from your home and/or custody through a 96-Hour Hold is necessary to ensure your
child(ren)'s safety and well-being. The reason for this action is:
The law allows the Department of Children and Families to hold your child(ren) for up to 96-hours
during which an assigned Social Worker will contact you regarding the Department's plans.
You may reach the office at _________________________, Monday through Friday from 8:30 a.m. to 4:30 p.m.
On weekends, after office hours and holidays, you may reach the Department by calling the
Child Abuse and Neglect Careline at
1-800-842-2288.
Name of designated person who authorized this removal::
Title:
Immediate Removal Effective:
TIME:
Social Worker Name
Signature
Department of Children and Families
IMMEDIATE REMOVAL / 96-HOUR HOLD OF CHILDREN
DCF-159
3/16 (Rev.)
Page 1 of 2
TO: Name of Parent(s) or Guardian(s):
Address: (No. and Street)
City
State
Zip
RE:
Name of Child:
DOB:
Name of Child:
DOB:
Name of Child:
DOB:
Name of Child:
DOB:
Name of Child:
DOB:
This is to advise you that, pursuant to Connecticut General Statutes §17a-101g, a duly authorized agent for the Commissioner of Children and Families
has determined that the immediate removal of your child(ren) from your home and/or custody through a 96-Hour Hold is necessary to ensure your
child(ren)'s safety and well-being. The reason for this action is:
The law allows the Department of Children and Families to hold your child(ren) for up to 96-hours
during which an assigned Social Worker will contact you regarding the Department's plans.
You may reach the office at _________________________, Monday through Friday from 8:30 a.m. to 4:30 p.m.
On weekends, after office hours and holidays, you may reach the Department by calling the
Child Abuse and Neglect Careline at
1-800-842-2288.
Name of designated person who authorized this removal::
Title:
Immediate Removal Effective:
TIME:
Social Worker Name
Signature