CarePortal Request

CASA volunteers can make CarePortal Requests for the children and families on their cases using this form.

Advocate Name*
Advocate Email*
Advocate Phone
Case Name/Number*
Names and Ages of Children Involved*
Are one or more of the children in out-of-home placement?*
- Yes
- No
How long has this case been open?*
What is the need you are submitting for?*
What is the approximate monetary value of the need?*
What other resources have you or the team used in order to meet this need?*
Caseworker's Name*
Caseworker's Contact Information*
Are you OK with being contacted directly by the person who would like to fulfill this need?*
- Yes
- No
Case Details*
Please tell us a bit about the case while still maintaining confidentiality. (i.s. This case has a 3-year-old male and a 5-year-old female living with great aunt after severe abuse from their parents. Aunt could use some assistance helping with back-to-school clothes and backpacks.)
Name
This field is for validation purposes and should be left unchanged.