NNorCal Family AdvocacyCPS · courts · family preservation

CPS and court intake · about 5–7 minutes

Tell us what happened in your CPS or family-court case.

We connect families and identify repeated problems involving child-welfare agencies, removal, placement, services, dependency court, and related family-court proceedings. You do not need to tell your whole story today.

Protect children’s privacy. Do not enter a child’s full name or confidential records here. We can arrange a private follow-up if records are needed.
1

Safe contact

Share only what feels safe today.

Are you in a safe situation to complete this form? *
Safest contact method

Your email connects you with your private survey record and allows authorized follow-up. It is not published.

May we email your private continuation link and occasional reminders to finish or update your survey? *
Is it safe to leave a voicemail?
May a text message identify NorCal Family Advocacy?
2

Your role and current case status

Start with who you are and where the case stands. Do not enter children’s full names.

Is CPS or child welfare contacting you now? *
Is this matter active now? *
Have you been involved in more than one CPS or dependency case?
Has a child recently been removed, or is removal currently being threatened? *
Important deadline or removal threat within 30 days? *
3

What happened

Select every concern that fits.

When did your CPS or dependency involvement occur?
Before removal or a threatened removal, were meaningful services offered that could have helped keep the child safely at home?
Did you have effective attorney representation throughout the important stages of the case?
Was a Child and Family Team (CFT) meeting offered before or soon after removal?
If removal occurred, what authority was explained to you?
Were you asked to agree to a safety plan?
Were your rights, court process, and appeal options explained in a way you understood?
Concerns in your experience
Records that may support your concerns
4

What help is wanted

Choose what would be useful now.

What would be most helpful?
May we contact you privately? *
Would you like to continue adding details now or return later? *
May we use your answers without identifying you in pattern reports? *

Your answers are stored privately for advocacy follow-up and pattern analysis.