Checklist for admission to Florence Crittenton Family Services.

The following items must be received prior to admission. If these items aren’t received, the admission process will be delayed:

• Birth Certificate (Copy of yours and any child’s)
• Medicaid/Insurance Card (Copy of yours and any child’s)
• Immunization Records (Copy of yours and any child’s)
• Medical Records (Your child(ren)’s)
• Current and Past Court Documents (If applicable)
• Documentation of Services child(ren) is/are enrolled in
• Verification of Pregnancy or Parenting Status
• Placement Agreement
• SNAP/TANF/WIC Documents (if applicable)
• Current Clinical/Psychological Evaluation
• Chemical Dependency Evaluation