Information and Forms for New Therapeutic Foster Parents

Here are links to the forms to be completed by prospective therapeutic foster parents.

Please download, print out and complete each form.

If you have any questions, please contact:

Beth Bernardone, Program Director
(914) 305-6891
beth.bernardone@fsw.org

When completed, please send the forms to:

Family Services of Westchester
Attn: Therapeutic Foster Care
106 North Broadway
White Plains, NY 10603

TFC Self Assessment Form

TFC Medical Report Form

TFC Personal References Form

TFC Resource Characteristics Form

TFC FP Agreement with Authorized Agency Form

OCFS-4930-ASFA Request for NYS Fingerprinting Services