CASA Volunteer Tracking Form

Welcome to our online Volunteer Tracking Form.  The link below is a fillable CASA Volunteer Tracking Form that can be completed, printed, and submitted to your Advocate Supervisor.

Volunteer Tracking Form

Online CASA Volunteer Tracking Form

To submit electronically, please complete the form below.  If you would like a copy of the completed form, please print before submitting.

Website URL
Completed by *		CASA Volunteer Supervisor
CASA Name
Date		/  /
Supervisor
Date appointed to the case		/  /
Docket #
Name of Child
# of Face-to-Face Contacts
Date(s) of Face-to-Face Contact with Child
# of Contacts by Phone
# of Contacts by Email
Date closed		/  /
Name of Child
# of Face-to-Face Contacts
Date(s) of Face-to-Face Contact with Child
# of Contacts by Phone
# of Contacts by Email
Date closed		/  /
Name of Child
# of Face-to-Face Contacts
Date(s) of Face-to-Face Contact with Child
# of Contacts by Phone
# of Contacts by Email
Date closed		/  /
Name of Child
# of Face-to-Face Contacts
Date(s) of Face-to-Face Contact with Child
# 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 Child
Time spent *
Mileage *
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 *		-- Ascension Office Assumption/St. James Office Felicianas Office Livingston Office St. Charles Office St. John Office Tangipahoa/St. Helena Office
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