Department of Children’s Services
INSTRUCTIONS FOR USE OF FORM
Relative Care Program Referral
The Relative Caregiver Program is available for relatives to care for non-custodial children who require
out-of-home care. Through RCP, the children and relative caregivers receive supportive services and
family advocacy in order to prevent children from entering and/or re-entering state custody.
Case managers, court staff, DHS, private providers, and any other community member may use the RCP
referral form to refer a client to the program. Each referent will complete the form to the best of their
ability with any information that they have for the family. If some information is not known it may be
left blank unless there is an asterisk indicating that it is required.
The referent will then e-mail, fax, mail, or hand-in the referral to the respective provider for their region.
Once the referral is sent, DCS case managers and other private providers with access will upload the
form into TFACTS for record that the referral was made.
Once RCP receives the referral they will contact the referent about successful receipt, and contact with