Volunteer Monthly Form Online
 

 

   
   
Remember to submit the report by the 5th of each month.
 
   

Report Month / Year          
CASA Name   (Last Name, First Name)  
Case Number          
Case Name          
Volunteer Supervisor          
Judge          
OCS case Manager     Has there been a Change? Yes  No  
Child's Attorney     Has there been a Change? Yes No  
Private Attorney   (Last Name, First Name)  
             

Child's Name

 Has there been a Placement Change this month? From  (Placement) To  (Placement)
Yes No
Have there been any incidents of abuse/neglect this month? Yes No
             
  # Of Contacts with Children        
  # of FAce-to-Face Contact     Total In-service Hours
  # Of Contacts with Collaterals     Total Case Hours
      # Of Contacts with Supervisor

 

PERSONAL NOTES: DESCRIBE A SUCCESS YOU HAVE HAD THIS MONTH. DESCRIBE ANY OBSTACLES YOU ARE ENCOUNTERING.

   
Was there a Family Team Conference this month? Yes  No  

                   (Date)
Was there a Court Hearing this month?   (type of Hearing) Yes  No  

                  (Date)
Do you have a recent picture of the child(ren) to attach to your next court report?  
Yes No 
Are services being provided as specified in the last case plan?  
Yes No   Partially
Is visitation occurring as planned?

Yes No   Partially
   

If your CASA child receives CAPES (education) funding, you must report all activities and progress this month specific to the approved/funded services in the comments section above.

   

Reminder:  Monthly Reports are due by the 5th of the following month.
Date of Next FTC    

 

  

Reminders
If no date set, next FTC is due    

  • is your Id badge current?  if not, please notify your advocate supervisor.

  • please complete a monthly face-to-Face contact exemption form if you have not had face-to-face contact with the child(ren).
Date of Next Court Hearing    
       

 
   
   
   
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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Capital Area CASA Association   341 St. Joseph Street  Baton Rouge  LA 70802
 

Phone: 225.379.8598    Fax: 225.379.3362    Email: info@casabr.org