CASA Volunteer Tracking Form

We are currently in the process of updating our online Volunteer Tracking Form.  Please click on the link below to download a printable CASA Volunteer Tracking Form and submit to your Advocate Supervisor.

Online CASA Volunteer Tracking Form

Completed by *		CASA Volunteer Supervisor
CASA Name
Date		/  /
Supervisor
Date appointed to the case		/  /
Docket #
Name of Child
# of Face-to-Face Contacts
# of Contacts by Phone
# of Contacts by Email
Date closed		/  /
Name of Child
# of Face-to-Face Contacts
# of Contacts by Phone
# of Contacts by Email
Date closed		/  /
Name of Child
# of Face-to-Face Contacts
# of Contacts by Phone
# of Contacts by Email
Date closed		/  /
Name of Child
# of Face-to-Face Contacts
# of Contacts by Phone
# of Contacts by Email
Date closed		/  /
Current placement of child(ren) *		Own home With relative Foster home Group home adoptive home Shelter Hospital Residential facility Indepentent living
Other
Has there been any change in placement this month? *		Yes No
If yes, from		-- Own home With relative Foster home Group home Adoptive home Shelter Hospital Residential facility Indepentent living
To		-- Own home With relative Foster home Group home Adoptive home Shelter Hospital Residential facility Indepentent living
Did child(ren)'s school change as a result of placement change? *		Yes No
If yes, from
To
Has there been a change in state caseworker this month? *		Yes No
If yes, from
To
Are siblings placed together? (Only applies when siblings are also in care) *		Yes No No siblings Siblings not in care
Is child(ren)'s placed in parish of home listed as permanent plan? *		Yes No
Have there been any incidents of abuse or neglect this month? *		Yes No
Are services being provided as specified in this last care plan? *		Yes No Partially
For current month contacts (number) with All Others
# in person *
# on the phone *
Time spent *
Mileage *
For current month contacts (number) with Supervisor
# in person *
# on the phone *
Time spent *
Mileage *
For current month contacts (number) with In-Service training (Does not include newsletter time)
Time spent *
Mileage *
For current month contacts (number) with Other CASA Contributions
# in person *
# on the phone *
Time spent *
Mileage *
Title(s) of in-service training attended this month
(30 minutes in-service if you read the newsletter) *		Yes No
Was there a Family Team Conference held this month? *		Yes No
Date of Family Team Conference		/  /
Were significant parties (including CASA) present at case planning? *		Yes No Partially N/A
Does case plan specify visitation? *		Yes No
Has visitation been occuring as planned? *		Yes No Partially
Does case plan specify a permanent plan? *		Yes No
Permanent plan is		-- Reunification Relative placement Adoption Long term foster care Independent living Other
Do you agree with permanent plan? *		Yes No
Was there a court hearing this month? *		Yes No
Date of court hearing		/  /
Did you attend the court hearing? *		Yes No N/A
Did you submit a court report? *		Yes No N/A
Did judge follow your recommendations? *		Yes No Partially N/A
Date of next scheduled court hearing		/  /
Other (Please state successes or obstacles experienced this month)
Email address
To *		-- Tangipahoa/St. Helena Office Livingston Office Felicianas Office Ascension Office St. Charles Office Assumption/St. James Office St. John Office
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