GA+SCORE - State of Georgia Out of Home Care

Instructions: Please answer each of the following required questions and click the 'Save and Continue' button. You will need to complete each of the five steps before submitting the record to the State Office CCTU. Until you click the 'Submit' button on step 5, you will be able to navigate to any page to enter/update information. Once you are ready, review the information you entered on step 5, then click 'Submit'. You will receive an email confirmation of your submission. You may click the 'Cancel Request' button at the top at any time to completely cancel your submission.

Submission Tracker: You can now return to your partial submission if you had to close your browser for any reason before final submission. Once you click the 'Save and Continue' button at the bottom of step 1, you'll immediately receive an email - check your spam box if you don't see it at first. The email includes a link to allow you to return where you left off and finish your submission following the instructions above. You will also be able to use the provided submission ID to check on the status of your request and upload additional documents using the new Submission Tracker.

Who is making the request? *
Primary Request Type: *
Is this an emergency request?
Initial request or renewal? *
Your Full Name: *
Your Phone Number: *
Email Address: *

DFCS County Name: *
First and Last Name of Child's DFCS Case Manager: *
DFCS Case Manager Phone Number: *
DFCS Case Manager Email Address: *
First and Last name of DFCS Supervisor: *
DFCS Supervisor Phone Number: *
DFCS Supervisor Email Address: *
First and Last Name of County DFCS Director: *
County DFCS Director Email Address: *