Form DCF-2111 "Disciplinary Agreement" - Connecticut

What Is Form DCF-2111?

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 June 1, 2017;
  • 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-2111 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-2111 "Disciplinary Agreement" - Connecticut

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DCF-2111
06/2017 (Rev.)
State of Connecticut
Department of Children and Families
DISCIPLINARY AGREEMENT
Section 17a-145-151(b) of the Regulations of Connecticut State Agencies states: “Foster and
prospective adoptive parents, members of the household, substitute care providers, and other
persons having regular access to children in the home shall give the child humane and
affectionate care. They shall be a positive role model to the child and instruct the child in
appropriate behavior. They shall establish limits and assist the child to develop self-control and
judgment skills. Children in the home shall be encouraged to assume age-appropriate
responsibility for their decisions and actions.”
Section17a-145-151(c) of the Regulations of Connecticut State Agencies states: “Discipline shall
be appropriate to the child’s age and level of development. Foster and prospective adoptive
parents shall not use physically or verbally abusive, neglectful, humiliating, frightening or
corporal punishment, including but not limited to spanking, cursing or threats.”
I agree to abide by the above Regulations.
___________________________________________________________
Printed Name
___________________________________________________________
___________
Signature
Date
Social Worker: (Witness)
___________________________________________________________
Printed Name
___________________________________________________________
___________
Signature
Date
Each member of the household age 18 years and older must sign a separate
Disciplinary Agreement.
DCF-2111
06/2017 (Rev.)
State of Connecticut
Department of Children and Families
DISCIPLINARY AGREEMENT
Section 17a-145-151(b) of the Regulations of Connecticut State Agencies states: “Foster and
prospective adoptive parents, members of the household, substitute care providers, and other
persons having regular access to children in the home shall give the child humane and
affectionate care. They shall be a positive role model to the child and instruct the child in
appropriate behavior. They shall establish limits and assist the child to develop self-control and
judgment skills. Children in the home shall be encouraged to assume age-appropriate
responsibility for their decisions and actions.”
Section17a-145-151(c) of the Regulations of Connecticut State Agencies states: “Discipline shall
be appropriate to the child’s age and level of development. Foster and prospective adoptive
parents shall not use physically or verbally abusive, neglectful, humiliating, frightening or
corporal punishment, including but not limited to spanking, cursing or threats.”
I agree to abide by the above Regulations.
___________________________________________________________
Printed Name
___________________________________________________________
___________
Signature
Date
Social Worker: (Witness)
___________________________________________________________
Printed Name
___________________________________________________________
___________
Signature
Date
Each member of the household age 18 years and older must sign a separate
Disciplinary Agreement.