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Vermont Judiciary

DCF Family Division Forms


Vermont Supreme Court

Welcome to the DCF Family Division Forms Page.  Here you will find the forms related to juvenile cases that might be helpful to a Family Services social worker.   All these forms are in .PDF Format.  You will need Adobe Reader to access these forms.  Click on the Form Name to access the form you would like to use.

If you have any questions regarding the DCF Family Division Forms on-line please contact the Family Division in the county in which you reside.

Click here to go to the Family Division's page.

Title Form Number
Authorization for Emergency Medical TreatmentAuthorization for Emergency Medical Treatment
Genetic Testing OrderForm 084
Restitution Judgment OrderForm 086
Care Plan for Child ~ Non Custodial ParentForm 089
Final Juvenile Protective OrderForm 090F
Emergency Juvenile Protective OrderForm 090T
Disposition Order-CHINSForm 091C
Disposition Order-DelinquencyForm 091D
Post-Disposition Review OrderForm 092
TPR Pre-Trial OrderForm 093
Juvenile Pick Up OrderForm 094
Transfer of Custody (Juvenile)Form 095
Emergency Care Order-Temporary Transfer of Custody to DCFForm 096
Temporary Care Order ~ CHINSForm 097C
Temporary Care Order ~ DelinquencyForm 097D
Conditional Custody OrderForm 098
Release of Custody OrderForm 099
Placement at Woodside OrderForm 100
Law Enforcement Juvenile Data SheetForm 101
Discharge from Juvenile ProbationForm 102
Juvenile Probation CertificateForm 106
Notice to Family Court of Adoption FinalizationForm 107
Juvenile Merits Stipulation FormForm 108
Notice of Intent Not to File Juvenile PetitionForm 109
Juvenile PetitionForm 110
Juvenile Conditions of ReleaseForm 111
Victim Impact Statement & Request FormForm 112
Notification to Victims of Juvenile Conditions of ReleaseForm 113
Permanency Findings & OrderForm 114
Order Determination of Reasonable EffortsForm 114a
Periodic Review ReportForm 115
Booklet for Parents in CHINS casesForm 116
Youth in CHINS Cases: Understanding the Court ProcessForm 117
Decision to Keep Juvenile Diversion Case UnsealedForm 119
Decision to Keep Juvenile Delinquency Case UnsealedForm 120
Order for Competency Eval of JuvenileForm 121
Juvenile Delinquency Proceedings PamphletForm 122
Referral to Approved Community Justice ProgramForm 124
Application for Public Defender Services - JUVENILEForm 358J
Juvenile Superintendent LetterJuvenile Superintendent Letter