Agency & Parental Forms

The following forms give more information regarding eligibility for placement, the specifics of our program, some do's and don'ts, and a list of items your child needs to bring if they are placed at the shelter.

Parent Letter

Parent Quick Reference Guide

Eligibility Criteria

The Youth Service Bureau of Monroe County now has forms online that you can print and fax to us to facilitate faster placement services. If you have questions regarding any of the following forms, please call us at 812-349-2507.

Fax # 812-349-2892

Brief Services Form

Agency Placement Agreement

Parental Placement Agreement

Medical Release

Permission to Obtain/Release Information

Release Authorization

Apprehension Authorization