Parental Intake Form

Parental Intake Form

 

This form MUST be completed by the Legal Guardian
of the missing child. No one knows your child like you do, please note authorized representatives of CFSI will NEVER offer to complete this form for you.
Once you have completed this form you will be directed to our States and Countries page
 which will show the State Coordinator and Regional Director for your state.

For pro bono services children must meet the criteria as follows:
Between the ages of 11- 16
Missing 90 days or less
Active case filed with Law Enforcement

Children missing more than 90 days, 10 and younger or 17 and older can be
referred to our network of for hire investigators.
 

   

Name Of Person(s) Completing Form: *

Contact Information Of Person(s) Completing This Form (Please Specify All Contact Information Including Address, City, State, Phone Numbers, Emails, Facebook, Or any other Social Media Contacts):

*Please include the best phone number to contact


 

Police Agency And Current Case Number:

*

Name of lead officer on case:

*

Phone number of lead officer on case:

*

-NCIC- number from law enforcement (*If available*):

Childs First Name:

*

Childs Last Name:

*

Childs State Last Seen:

Childs City Last Seen:

*

Childs Nickname:

Childs Current Age:

*

Childs Date Of Birth:

*

Childs Height and Weight:

*

Childs Hair Color:

*

Childs Hair Style/Length:

Childs Eye Color:

*

Does The Child Wear Contact Lenses?:

Does The Child Wear Glasses:

Teeth Appearance:

Does The Child Wear Braces?:

Does The Child Have any Birthmarks or Scars?:

Does The Child Have Any Piercings Or Tattoos? (Please Specify Location Of Piercing/Tattoo and Shape/Color):

Does The Child Have Any Abnormalities or Distinguishing Features?:

Does The Child Take any medications?:

Childs School Name And Grade Attending/Last Attended:

*

Does The Child Have Any Medical Issues?:

Who Is The Childs Current LEGAL Guardian?:

*

At whose residence does the child reside? (Moms, Dads, Grandparents, Legal Guardian, Etc?):

*

Name Of Said Person(s) Of Which the Child Resides With (Please List Names Of All Persons In Household And Their Relationship To The Child):

*

Address Of Childs Current Residence:

*

State Of Childs Current Residence:

City Of Childs Current Residence:

*

Secondary Or Other Residence:

Childs Contact Phone Numbers:

Childs Contact Email Addresses:

When Was The Child Last Seen?:

*

What Is The Name(s) Of The Persons(s) The Child Was Last Seen With?:

Please Describe The Circumstances Surrounding The Time Your Child Went Missing. (At Least 48 Hours Prior):

*

Please Describe What The Child Was Wearing When They Went Missing:

What Items Did The Child Take With Them?:

Do you have access to the child's phone records?:
Does the child have a bank account? If yes, do you have access?:
Does the child have a driver's license? If yes, please provide the number.:
Does the child have a vehicle? If yes, please provide the tag number.:
If applicable, please provide the tag number of any vehicles belonging to the child's friends.:

Does The Child Have A Facebook, Twitter, XBox Live, MSN, Skype, Or Any Other Social Media Accounts? (Please Give User Name And Passwords If Known):

Does The Child Have Any Best Or Close Friends? If So Please Provide All Known Contact Information Including Phone Numbers, Addresses, Cities, States, Facebook Names (Or Any Other Social Media Or Online Contacts) ::

Is There Any Other Information You Would Like To Provide On The Boyfriend/Girlfriend (I.E. Their Parents Contact Info, Where They Hang Out, Prior Criminal Activity, Gang Associations, Etc.):

Is There any other Organization or Private Investigator that you are receiving help from? Please list Organizations and or Private Investigator names. "I am aware that to maintain case confidentiality and integrity, CFSI does not share information with other Organizations or Private Investigators."

I agree that all photos provided of my child by the parent or guardian to C.F.S.I. may be used for the creation and distribution of a missing flyer and in other efforts to locate the child. I am also aware that these photos will be seen publicly while the child is missing and may continue to be seen after the child is found. I understand that any take down of missing flyers after location of child is my responsibility. In Addition, I agree that have disclosed any Organizations or Private Investigators that we are receiving help from at this time. I also give full right to C.F.S.I. to share information at their discretion as needed in any and all searches related to or in direct correlation to finding the child I have submitted as the legal guardian such as but not limited to locations of interest. Information that could be deemed sensitive shall remain confidential. (Please click the arrow on the right to make your selection if you agree. This is required)
At legal guardians request CFSI will make every effort to remove our posts of a child's missing poster,  however this does not guarantee removal in entirety from the internet.
   
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