Forms

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JCS / COS TRANSPORTATION

JCS / COS Transportation Referral

DHS CONTRACTS
These forms are to be used for DHS workers that have contracts wtih CIJDC to perform these services
Family Team Meetings	Transportation / Supervised Visits	Support Services

DHS INDIVIDUALIZED ASSISTANCE

This forms is to be used for DHS Workers referring transportation using Individualized Assistance as the Funding Source

DHS COURT ORDERED SERVICES
These forms are to be used for DHS Workers referring transportation using Court Ordered Service Funds
DHS COS Trasportation / Supervised Visit Referral	COS Approval Form - Ames Service Area ONLY

General Forms
Federal I-9 Federal W-4 Iowa W-4 IPERS Application Acknowledgment & Direct Deposit Employee Voluntary Withholding	Orientation Letter - CSC CSC Health Screening Report of Suspected Child Abuse Mandatory Reporter Curriculum Mandatory Reporter Exam	Transportation Mileage Chart Orientation Letter - Transporter Supervised Visit Report

1st District Tracking Forms
Tracking Claim Payroll Letter Job Description D1 Tracker Intensive Supervision Contract Group - Alcohol Group - Character Group - Goal Setting Group - Peer Pressure	Tracker Referral Life Skills School Map Intensive Supervision Schedule Group - Anger Management Group - Communication Group - Law Education/Rules Group - Self Esteem	Anger Management Intensive Supervision Guidelines CIJDC Email Instructions Group - ALL Group - ART Documents Group - Empathy/Victim Impact Group - Miscellaneous

2nd District Tracking Forms
Tracking Time Sheet Tracking Time Sheet - Sample Tracking Travel Claim Tracking Travel Claim - Sample	Tracking Guidelines Tracking Discharge Tracking Discharge - Instructions Tracking Discharge - Computerized D2 Interpreting Timesheet D2 Interpreting Timesheet- SAMPLE	Tracking Consequences Tracker Initial Health Screening Tracking Referral Tracking Referral- SAMPLE Paid Time off sheet Orientation Letter - Tracker

6th District Tracking Forms
Tracking Time Sheet Tracking Time Sheet - Sample	Tracking Travel Claim Tracking Travel Claim - Sample Tracking Referral	Tracking Discharge - 6th District Tracking Discharge - Computerized Tracking Discharge - Instructions

1st District JCS Wrap Around Forms
D1 Wrap Around Referral

Drug & Alcohol Testing
	Job Description - Drug Testing Specialist

County Specific Tracking Forms
Story Co. - Tracking Supervision Contract Story Co. - Tracking Weekly Schedule	Tracking Level I Contract Tracking Level II Contract Tracking Level III Contract	Tracking Violation Contract Tracking Violation Report

Wellmark Insurance Forms	Flex Benefit Forms
Dental 205 Drug Benefit Health Benefit U19 Life Coverage Health Insurance Application	Flex Brochure POP Brochure Dependent Care Brochure Generic Claim Form	Enrollment Form Medical Brochure 2007 Calendar