Form JD-JM-120A "Family With Service Needs Parental Notice" - Connecticut

What Is Form JD-JM-120A?

This is a legal form that was released by the Connecticut Superior Court - 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 August 1, 2017;
  • The latest edition provided by the Connecticut Superior Court;
  • 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 JD-JM-120A by clicking the link below or browse more documents and templates provided by the Connecticut Superior Court.

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Download Form JD-JM-120A "Family With Service Needs Parental Notice" - Connecticut

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FAMILY WITH SERVICE NEEDS
STATE OF CONNECTICUT
PARENTAL NOTICE
SUPERIOR COURT
JUVENILE MATTERS
JD-JM-120A
Rev. 8-17
C.G.S. §§ 46b-120; 46b-149; P.A. 16-147 § 7
www.jud.ct.gov
As a parent or guardian, making the decision to refer your child to the court as a child from a Family with Service Needs
(FWSN) may be difficult, but may be necessary when you believe your child needs help for certain behaviors. The FWSN
statute applies to children (up to age 18) who run away or demonstrate out of control behavior.
The FWSN process is intended to assist you and your child to resolve the issues related to the behavior of the child. You, as
the parent or guardian, working with the Probation Officer and other people, are key to a successful outcome. To help you
make an informed decision about filing a FWSN complaint, the following information is for parents and guardians. After you
have filed a FWSN complaint you can expect:
• In some cases a referral will be made to a Child,Youth, and Family Support Center (CYFSC) for handling. The
CYFSC, operated by a private agency, provides crisis intervention, short term respite, assessment and evaluation.
This service is designed to work with the child and family to address the issues which led to a parent referring the child
to the court.
• One or more meetings with a Juvenile Probation Officer (JPO) to assess your family's needs. You may be asked to
sign Releases of Information allowing the Juvenile Probation Officer to contact your child's school and other agencies
that you are working with now, or have worked with in the past. Sometimes, referrals for clinical assessments are also
necessary. You and your child may have to see a licensed professional.
• In some cases, services needed by your child may be met by a referral to the Department of Children and Families
(DCF) for Voluntary Services. DCF may also become involved with your family if the court believes your child needs
to be placed out of the home and commits your child to the custody of DCF.
• Before any court hearing or court order, your child has the right to have an attorney represent him or her. If you meet
financial eligibility guidelines, your child will be provided a state-paid attorney by the Office of the Chief Public
Defender. If you do not meet the financial guidelines, you will have to pay for your child's attorney.
• In general there will be no, or limited cost, to you for the services provided to you and your child. You may be
responsible for a "co-pay'' based on your insurance coverage. If your child needs a court ordered inpatient
hospitalization or residential placement, you may have to pay for some of those costs.
• All the practices and procedures of the Juvenile Probation Officers are regulated by law and Judicial Branch policies.
Since they work within the framework of the law, they can only act within permitted guidelines. Sometimes, these
policies and guidelines may conflict with your wishes or desires in the case, but you should understand that every
effort is made to work with you and to help your child and family.
• The effort to resolve the problems always requires the on-going commitment of the parents or guardian to work with
professionals. You should be prepared to make this commitment before making a referral to the court.
If you have any questions before filing this complaint, you may ask to speak with the Probation Supervisor. If you do not have
other questions, please sign below to indicate that you have read this notice and understand the information in it.
Date
Child's name
Signed (Parent/Guardian)
ADA Notice
The Judicial Branch of the State of Connecticut complies with the Americans with
Disabilities Act (ADA). If you need a reasonable accommodation in accordance with
the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA.
Print Form
Reset Form
FAMILY WITH SERVICE NEEDS
STATE OF CONNECTICUT
PARENTAL NOTICE
SUPERIOR COURT
JUVENILE MATTERS
JD-JM-120A
Rev. 8-17
C.G.S. §§ 46b-120; 46b-149; P.A. 16-147 § 7
www.jud.ct.gov
As a parent or guardian, making the decision to refer your child to the court as a child from a Family with Service Needs
(FWSN) may be difficult, but may be necessary when you believe your child needs help for certain behaviors. The FWSN
statute applies to children (up to age 18) who run away or demonstrate out of control behavior.
The FWSN process is intended to assist you and your child to resolve the issues related to the behavior of the child. You, as
the parent or guardian, working with the Probation Officer and other people, are key to a successful outcome. To help you
make an informed decision about filing a FWSN complaint, the following information is for parents and guardians. After you
have filed a FWSN complaint you can expect:
• In some cases a referral will be made to a Child,Youth, and Family Support Center (CYFSC) for handling. The
CYFSC, operated by a private agency, provides crisis intervention, short term respite, assessment and evaluation.
This service is designed to work with the child and family to address the issues which led to a parent referring the child
to the court.
• One or more meetings with a Juvenile Probation Officer (JPO) to assess your family's needs. You may be asked to
sign Releases of Information allowing the Juvenile Probation Officer to contact your child's school and other agencies
that you are working with now, or have worked with in the past. Sometimes, referrals for clinical assessments are also
necessary. You and your child may have to see a licensed professional.
• In some cases, services needed by your child may be met by a referral to the Department of Children and Families
(DCF) for Voluntary Services. DCF may also become involved with your family if the court believes your child needs
to be placed out of the home and commits your child to the custody of DCF.
• Before any court hearing or court order, your child has the right to have an attorney represent him or her. If you meet
financial eligibility guidelines, your child will be provided a state-paid attorney by the Office of the Chief Public
Defender. If you do not meet the financial guidelines, you will have to pay for your child's attorney.
• In general there will be no, or limited cost, to you for the services provided to you and your child. You may be
responsible for a "co-pay'' based on your insurance coverage. If your child needs a court ordered inpatient
hospitalization or residential placement, you may have to pay for some of those costs.
• All the practices and procedures of the Juvenile Probation Officers are regulated by law and Judicial Branch policies.
Since they work within the framework of the law, they can only act within permitted guidelines. Sometimes, these
policies and guidelines may conflict with your wishes or desires in the case, but you should understand that every
effort is made to work with you and to help your child and family.
• The effort to resolve the problems always requires the on-going commitment of the parents or guardian to work with
professionals. You should be prepared to make this commitment before making a referral to the court.
If you have any questions before filing this complaint, you may ask to speak with the Probation Supervisor. If you do not have
other questions, please sign below to indicate that you have read this notice and understand the information in it.
Date
Child's name
Signed (Parent/Guardian)
ADA Notice
The Judicial Branch of the State of Connecticut complies with the Americans with
Disabilities Act (ADA). If you need a reasonable accommodation in accordance with
the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA.
Print Form
Reset Form