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Intake

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  • QUESTIONS ABOUT YOU

  • SERVICES & REFERRALS OFFERED

  • Instructions: Please select any area you would like additional information or assistance in.
  • Strengths - List three family strengths
  • Goals

  • What are three goals you have for yourself?
  • What are three things you hope to learn in this parenting program?
  • PERMISSION FOR RELEASE OF INFORMATION

  • Our ability to offer this class to you at no charge is due to a grant from Children’s Trust Fund. Part of our grant requirements are to collect child support payment data. This data is shared only with Children’s Trust Fund. The Family Center does not release this information to any other organization. Child Support requires that The Family Center provide a release of information to obtain the information needed for the grant.

    I have been informed of my rights concerning the release of confidential information and I give my permission for The Family Center to obtain child support information to include but not limited to amount and payment history from DHR/ Child Support Enforcement.

    This release of information shall expire in 12 months or upon case closure, whichever occurs sooner:
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To strengthen families and prevent child abuse and neglect by providing free and low cost education, training and support to parents and caregivers in Southwest Alabama.

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April is child abuse awareness month and you can help prevent child abuse by purchasing a virtual pinwheel. Click the link below for more information.
https://pinwheels.preventchildabuse.org/

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