Form DCF-2084 "Adolescent Case Transfer Conference" - Connecticut

What Is Form DCF-2084?

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 April 1, 2015;
  • 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 printable version of Form DCF-2084 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-2084 "Adolescent Case Transfer Conference" - Connecticut

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DCF-2084
04/2015 (Rev.)
DEPARTMENT OF CHILDREN AND FAMILIES
ADOLESCENT CASE TRANSFER CONFERENCE
Case Name:
LINK Case Number:
Youth’s Name:
Date of Birth:
F ☐
Ethnicity:
Gender:
M
Committed ☐
TPR ☐
Other ☐
Number of Placements:
Legal Status:
Current Placement Type (check one)
Home
DCF Facility
Residential Treatment Center
Foster
Shelter
Detention
Other (specify):
Group Home
Hospital
Anticipated Discharge Date from Current Placement:
Anticipated Next Placement Type (check one)
Home
DCF Facility
Residential Treatment Center
Foster
Shelter
Detention
Group Home
Hospital
Other (specify):
Treatment Plan Goal:
Yes ☐
No ☐
Have Reasonable Efforts Been Deemed No Longer Appropriate?
Yes ☐
No ☐
Is there a Compelling Reason not to Transfer the Case?
(If yes, please explain):
Yes ☐
No ☐ (If yes, please answer a, b, & c)
Is the Youth a Parent?
a.
Number of Children:
Yes ☐
No ☐
b.
Is (Are) the Child(ren) Committed to DCF?
Yes ☐
No ☐
c.
Does (Do) the Child(ren) Reside with the Parent being Reviewed at the
Transfer Conference?
1
DCF-2084
04/2015 (Rev.)
DEPARTMENT OF CHILDREN AND FAMILIES
ADOLESCENT CASE TRANSFER CONFERENCE
Case Name:
LINK Case Number:
Youth’s Name:
Date of Birth:
F ☐
Ethnicity:
Gender:
M
Committed ☐
TPR ☐
Other ☐
Number of Placements:
Legal Status:
Current Placement Type (check one)
Home
DCF Facility
Residential Treatment Center
Foster
Shelter
Detention
Other (specify):
Group Home
Hospital
Anticipated Discharge Date from Current Placement:
Anticipated Next Placement Type (check one)
Home
DCF Facility
Residential Treatment Center
Foster
Shelter
Detention
Group Home
Hospital
Other (specify):
Treatment Plan Goal:
Yes ☐
No ☐
Have Reasonable Efforts Been Deemed No Longer Appropriate?
Yes ☐
No ☐
Is there a Compelling Reason not to Transfer the Case?
(If yes, please explain):
Yes ☐
No ☐ (If yes, please answer a, b, & c)
Is the Youth a Parent?
a.
Number of Children:
Yes ☐
No ☐
b.
Is (Are) the Child(ren) Committed to DCF?
Yes ☐
No ☐
c.
Does (Do) the Child(ren) Reside with the Parent being Reviewed at the
Transfer Conference?
1
Yes ☐
No ☐
Has the Youth ever been Arrested? (If yes, please answer a & b)
Yes ☐
No ☐
a.
Are there Charges Pending?
Yes ☐
No ☐
b.
Is the Youth Currently on Probation?
Yes ☐
No ☐
Has the Youth ever been Involved in Substance Abuse?
Yes ☐
No ☐
Is the Youth Currently Enrolled in an Educational program?
If no, Does the Youth Plan to Attend a Post-Secondary Education Program?
Yes ☐
No ☐
Unknown ☐
DHMAS ☐
DMR ☐
BRS ☐
Is It Anticipated that the Youth will Need a Referral to:
Yes ☐
No ☐
Transfer Decision
Signatures
Youth’s Social Worker:
Date:
Youth’s Social Work Supervisor:
Date:
Adolescent Services Supervisor:
Date:
Adolescent Program Manager
__________________________________________
Date:
IF THE CASE IS BEING TRANSFERRED, PLEASE COMPLETE THE CASE
TRANSFER SUMMARY
2
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