Foster Parents’ Information

DCFS wishes anyone dealing with COVID-19 a quick and complete recovery. We would like to make sure that this matter is handled appropriately. To do so, we need your participation. Please complete the following questionnaire.

Foster Parent’s Name:

Name of spouse:

Name of foster child/children placed in the home and worker’s name:

Does the foster parent(s)/caregiver(s) have any symptoms that can be attributed to Covid-19?

If yes, describe the symptoms for each foster parent/caregiver.

What day did the symptoms begin?

Has the foster parent(s)/caregiver been tested for Covid-19?

If yes, what day did the foster parent/caregiver test?

Has the foster parent/caregiver received the test results

Has the foster parent/caregiver tested positive?

Has the spouse been tested for Covid-19?

If yes, what day were the results received?

If yes, what day did the spouse test?

What day did each foster parent/caregiver begin quarantining?

How long is the quarantine period for each foster parent/caregiver? (Ex. 14 days)

If the foster parent(s)/caregiver(s) do not have any symptoms and have not tested positive, has the foster parent(s)/caregiver(s) been identified as being a close contact to a person that has tested positive for COVID-19?

Note: An additional form should be completed for each foster child in the home if they have tested positive or have come into close contact with someone that has tested positive.

Additional comments

Has the spouse tested positive?

Has the spouse received the test results?