CPS’s Fathers Referrals for FOCUS+

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CPS FOCUS+ Father's Referral

Note: If father has been convicted of child sexual abuse or it has been determined that he is RTB of child sexual abuse, he CANNOT attend FOCUS+ classes.
Effective 4/3/2020, PAYMENT AUTHORIZATION (2054) IS REQUIRED.
Please send payment authorization to focusadmin@newdayservices.org

CPS FOCUS+ for Fathers Referral Form

* Indicates required field

Check One *

CPS-CVS CPS-FBSS CPS-Inv OC-OK-CVS Region 2

PRIMARY LANGUAGE *

English Spanish

*CLASSES ARE HELD AT VARIOUS TIMES & LOCATIONS*
The FOCUS+ for Fathers' staff will reach out to you or the father to determine the best location.

Special Note: we are having issues with Austin and our DFPS contract. They have temporarily put our contract on hold. We expect to resolve these issues soon.

Referring County *

Caseworker Name *

Caseworker's Phone Number *

Caseworker Email *

Case # *

Case Name *

Father's Name *

Father's Cell *

Father's Email *

Alternative # *

Father's Date of Birth *

Is this a SAFE BABIES Tarrant County Case? *

Yes No

Is this case related to a Domestic Violence charge? *

Yes No

Is Father considered the RTB for DV? *

Yes No Undetermined

NOTE: (In Tarrant County Only): In addition to the FOCUS Class for Fathers, we MAY be able to connect your client to other services which may or not be on their service plan. Please check all that apply. *

Anger Management Co-Parenting Skills

Make any additional comments here: *

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Who we are
Our Services
Referrals
CONNECT WITH US
DONATE
- Monthly Support
- Other ways to Give