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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
Notice to Victim of Rights and Responsibilites - Listed
Notice to Victim of Rights and Responsibilites - Non-Listed
Notice to Victim of Rights and Responsibilities - Youthful Offender
Notice of Disposition of Juvenile Case
Juvenile Protective Order
Emergency Juvenile Protective Order
Disposition Order - CHINS
Disposition Order - Delinquency
Juvenile Pickup Order
Transfer of Custody Order
Emergency Care Order
Temporary Care Order
Temporary Care Order - Delinquency
Conditional Custody Order
Emergency Conditional Care Order
Order Re: Placement at Woodside
Notice of Juvenile Conditions of Release
Permanent Guardianship Letter
Agreement for Post-Adoption Contact or Communication400-00126
Authorization for Emergency Medical TreatmentAuthorization for Emergency Medical Treatment
Genetic Testing OrderForm 084
Juvenile Parentage OrderForm 085
Restitution Judgment OrderForm 086
Citation to JuvenileForm 087
Affidavit of Child Custody (UCCJA)Form 088
Care Plan for Child ~ Non Custodial ParentForm 089
Post-Disposition Review OrderForm 092
TPR Pre-Trial OrderForm 093
Order to Vacate Conditional Custody OrderForm 098V
Release of Custody OrderForm 099
Law Enforcement Juvenile Data SheetForm 101
Discharge from Juvenile ProbationForm 102
Probation CertificateForm 106
Youthful Offender Probation CertificateForm 106YO
Youthful Offender Probation Certificate (Sex Offense)Form 106YOSO
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
Victim Impact Statement & Request FormForm 112
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
Order of Dismissal CriminalForm 137
Application for Public Defender Services - JUVENILEForm 358J
YO Determination & OrderForm 81
YO Discharge Order Family DivisionForm 82
YO Entry Order Youthfull Offender ReportForm 83
Juvenile Superintendent LetterJuvenile Superintendent Letter