LINKAGES forms can be accessed by both DCFS and DPSS staff using the links below.

DCFS 800
Used by DCFS to refer a family to Family Preservation services.

  • Click here to view a sample DCFS 800.
  • DCFS staff: use the Family Preservation database to generate a DCFS 800.

DCFS 802
Signed by a family  receiving Family Preservation services to authorize DCFS to share information with DPSS.

  • Click here to view a sample DCFS 802.
  • DCFS staff: click here to generate a DCFS 802 from LAKids.

DCFS 5122
A Screening Tool used to determine a DCFS family's potential eligibility to DPSS benefits.

  • Click here to view a sample DCFS 5122.
  • DCFS Clerical Staff: use the CWS/CMS to generate a DCFS 5122.

DCFS 5230
Used by both DPSS and DCFS to facilitate service coordination for families involved in Family Reunification and GAIN.

  • Click here to view a sample DCFS 5230.
  • DCFS Staff: click here to generate a DCFS 5230 through LAKids.
  • Linkages GAIN Services Worker: to access the DCFS 5230 form, contact your GAIN Services Supervisor.
Information Request Form

Used by CSWs to initiate Case Consultation with LGSW.

  • Click here to view a sample Information Request Form. 
  • DCFS Staff and LGSW: Click here to generate an Information Request Form.

GN 2016
Used by both DPSS and DCFS to facilitate service coordination for families involved in Family Preservation and GAIN.

  • Click here to view a sample GN 2016.
  • DCFS Staff: Click here to generate a GN 2016 through LAKids.
  • DPSS Family Preservation GAIN Services Worker/Supervisor: Click here to generate a GN 2016 through MyDPSS Forms Library.

GN 6007B
Used by DCFS contracted Family Preservation (FP) agencies to notify the FP GAIN Services Worker of completion or termination of FP services. 

GN 6008
Used by providers to report progress on Welfare-to-Work plan activities for families involved in Family Preservation and GAIN.