Fostering and Adoption Form

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1. If you want to find out more about adoption, fostering, short breaks or supported care and have read all of the related content please complete the information below and one of our team will be in touch soon to arrange a home visit.
2. Privacy Notice - Children and Families
How did you hear about the service?
1. HEARSERVICE
  
  Word of Mouth
  
  West Lothian Bulletin
  
  Social Media
  
  Other Fostering or Adoption Agency
  
  Other
2. Please advise
Please select which services you are interested in?
1. Adoption
2. Fostering
3. Intensive Fostering
4. Short Breaks
5. Supported Care
Your Details
1. First Enquirer
2. Full Name*
3. Date of Birth*
4. Your address
  1. Your Address
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  4. Your Address
    
    OSG Postcode Search (Custom drop-down list)
    
    Postcode
    
    Address
5. Contact Number*
6. Email Address *
7. If you are employed, how many hours a week on average do you work?
8. What is your preferred method of contact?*
  
  Email
  
  Phone
9. Is this a joint enquiry?*
  
  Yes
  
  No
Second Enquirer
1. If this is a joint enquiry please complete details for both enquirers.
2. Name
3. Date of Birth
4. Your address
  1. Your Address
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  4. Your Address
    
    OSG Postcode Search (Custom drop-down list)
    
    Postcode
    
    Address
5. Contact Number
6. Email Address
7. If you are employed, how many hours a week on average do you work?
Enquiry Details
1. Does anyone in the household smoke?*
  
  Yes
  
  No
2. If you are living with a partner have you been residing together for over two years?*
  
  Yes
  
  No
  
  Not living with a partner
3. Why do you think you would like to become an adoptive/foster/short breaks/supported care carer?*
4. Do you have children living at home?*
  
  Yes
  
  No
Children Details
1. Please provide the name and date of birth for each child living within the home.
2. Child 1
  1. Name
  2. Date of Birth
    
    Day
    
    Month
    
    Year
  3. Label
3. Child 2
  2. Name
  3. Date of Birth
    
    Day
    
    Month
    
    Year
  4. Label
4. Child 3
  2. Name
  3. Date of Birth
    
    Day
    
    Month
    
    Year
  4. Label
5. Child 4
  2. Name
  3. Date of Birth
    
    Day
    
    Month
    
    Year
  4. Label
6. Child 5
  2. Name
  3. Date of Birth
    
    Day
    
    Month
    
    Year
  4. Label
7. Child 6
  2. Name
  3. Date of Birth
    
    Day
    
    Month
    
    Year
  4. Label
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1. Do you consent to us undertaking initial checks of our social work system to enable us to proceed to an initial interview?*

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Fostering and Adoption Form

Your Address

Your Address