Child Abuse Prevention Agency
A&E Family Services
improving family life,
knowledge and understanding
Intake Forms for Visits, Exchanges, Monitored Phone Calls
Please download and print out the documents. Fill all pages completely and provide them to staff in order to schedule your INTAKE appointment along with all the requested and required documents. This document may be filled out on the computer or hand written. We must receive live signatures, so you may not email or fax these forms.
please include all the additional documents you need to provide along with the basic packet, please insure that you have done so or there will be a delay in scheduling the appointment and the visits.
We request payment in advance of the Intake appointment. For your ease and convenience we accept payment on-line through Paypal. You may submit payment in the mail with cash or money orders as well. Payment needs to be received prior to the appointment being scheduled. Thank you.
Please call or email if you have questions. email@example.com
Emails will be responded to much more quickly than voice mails. Emails are required for arranging visits and scheduling exchanges. This is for your protection and for the sake of clarity.
Complete Intake Packet
Authorized Person Form
Please complete this form and provide a copy of the California Driver's license and active Automobile Insurance policy for each person who may pick up or drop off the children besides their legal parents/guardians. These documents need to be provided well in advance of a drop off or pick up.