FOSTER CHILD METH EXPOSURE FORM

This form is to advise you as the Foster Parent(s) that the child(ren) that you are taking into your home has been exposed to methamphetamine and or the chemicals that are involved with the making of methamphetamine drugs.  You are advised not to take children into your home without proper notification and explanation of exposure. 

_____  The child(ren) were exposed to a fully operating meth lab.

 _____  The child(ren) were exposed to meth chemicals only.

 _____  The children have been examined by a physician prior to the placement in

            your home.

 _____  The child(ren) HAVE been decontaminated.

 _____  The child(ren) have been given a clean bill of health by the examining

            physician.

 _____  The child(ren) HAVE NOT been decontaminated.

§         Child should shower using warm water, soap and shampoo as soon as

possible.

§         Discard child’s clothing, DO NOT wash.

§         Clean tub with 5% bleach solution (5% bleach, 95% water).

 _____  The worker has discussed the need for new clothing for the foster child(ren)

            and what is involved in terms of purchasing these items.

_____  Verification of child exposure and health has been shown to you as the Foster

            Parent.

List of items needed:

1.

 2.

 3.

 4.

 5.

 6.

 Worker Signature: ____________________________________ Date: _____________

 Foster Parent Signature: _______________________________ Date: _____________

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