RTFT Plan (20220823) RTFT Plan 2022-08-23 REUNIFICATION AND THERAPEUTIC FAMILY TIME PLAN Name of Parent/Guardian* First Last Name of Child* First Last Date of Birth* MM slash DD slash YYYY Are there other children? Yes No Name of Child (2) First Last Date of Birth MM slash DD slash YYYY Name of Child (3) First Last Date of Birth MM slash DD slash YYYY Name of Child (4) First Last Date of Birth MM slash DD slash YYYY Date of Referral* MM slash DD slash YYYY Date of Initial Meeting* MM slash DD slash YYYY Names of Attendees*Current ContactIs phone communication currently occurring?* Yes No If yes, with whom?* Is written correspondence occurring?* Yes No If yes, with whom?* Therapeutic Family Time Schedule, location and transportation arrangements:*Risk concern(s) and plans to address any identified concerns:*Is there anyone who may not have contact with the child(ren) and why?*Who will participate in Therapeutic Family Time?*Name of contact person for rescheduling visits First Last Phone number of contact person for rescheduling visits*Rescheduling procedures*Scheduling barriers to consider?*Special conditions affecting Therapeutic Family Time?*(e.g., health, court orders, cultural issues, etc). Parent/Guardian signature (1)* Parent/Guardian signature (2) Resource parent signature DCF SW signature RTFT worker signature* Today's date* MM slash DD slash YYYY
