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WINS Child in Need of Service Referral Form To: WINS/FINS COMMUNITY BASED COUNSELOR From: Date: Name of Student: Student is: or Runaway, Truant, School: Grade: is at risk of becoming: Ungovernable
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How to fill out CINS (Child in Need) form:

01
Begin by carefully reading the instructions provided with the form. Familiarize yourself with the purpose and requirements of the CINS form to ensure accurate and complete information.
02
Start by clearly providing your personal information, including your full name, address, contact number, and email address. This will help the authorities reach out to you if further information is required.
03
Provide the details of the child who is in need, including their name, age, date of birth, and any other relevant identification details. It is important to provide accurate and up-to-date information to ensure appropriate support and care for the child.
04
Indicate the reasons why the child is in need of assistance. Describe the specific challenges, difficulties, or circumstances that make the child eligible for support. Be concise and clear in your explanations.
05
Include any relevant supporting documentation that can help prove the child's need for assistance. This may include medical reports, psychological assessments, or legal documents, depending on the situation. Make sure to attach copies of these documents to the form.
06
Provide information about any existing support networks or services that the child is currently receiving. This can include details about schools, healthcare providers, therapists, or any other professionals involved in the child's care. This information helps authorities understand the child's current situation and coordinate services effectively.
07
If applicable, provide the details of any individuals who may be involved in the child's care, such as parents, guardians, or other family members. Include their names, contact information, and relationships to the child.
08
Lastly, sign and date the form to acknowledge that the provided information is true and accurate to the best of your knowledge.

Who needs CINS (Child in Need)?

01
Children who are subjected to abuse or neglect within their family or care environment may require CINS support. This can include physical, emotional, or sexual abuse, as well as neglect in terms of basic needs such as food, shelter, and education.
02
Children with disabilities or special needs who require additional support and services may also be eligible for CINS. These children may face challenges in their daily lives and could benefit from specialized care and assistance.
03
Children who are at risk of harm due to factors such as parental substance abuse, domestic violence, or parental mental health issues may also need CINS support. These circumstances can have a significant impact on a child's well-being and safety, warranting intervention and support.
It is important to remember that eligibility for CINS may vary depending on the jurisdiction and specific laws in place. It is recommended to consult local authorities or social services for precise information on who needs CINS support in your area.
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CINS stands for Child in Need of Services. It refers to a legal designation that allows the state to provide intervention for children who may be at risk of harm or neglect.
Typically, a Child Protective Services (CPS) agency or social worker is responsible for filing a CINS petition for a child in need.
To fill out a CINS petition, specific information about the child's situation, family background, and reasons for intervention must be provided.
The purpose of a CINS petition is to ensure that children who are at risk of harm or neglect receive the necessary support and intervention to protect their well-being.
Information such as the child's living situation, family history, any past incidents of abuse or neglect, and current concerns regarding the child's safety must be reported on a CINS petition.
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