[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-276941-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-276941-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","agreement-for-temporary-custody-of-child","Agreement for Temporary Custody of Child","","Agreement for temporary custody establishes roles and responsibilities between an Ohio parent/guardian/custodian and an authorized agency. The parent authorizes temporary custody for child placement and planning supportive services, while the parent agrees to financial responsibility for specified support and health care and to provide timely address/telephone updates. The agency agrees to provide approved substitute care, arrange visitation, consent to necessary medical services, support education needs, and gather relevant records. The document also defines information release limits, agreement period, and termination and extension procedures.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/letters/","Letters",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/agreement-for-temporary-custody-of-child/276941/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/agreement-for-temporary-custody-of-child/276941.png","ImageObject",442,249,{"name":42,"@type":43},"Graffin","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-25","2026-09-15",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",16,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What authorization does the parent/guardian/custodian provide in Part I?","Question",{"text":63,"@type":64},"The parent/guardian/custodian authorizes the agency to assume temporary custody. Signing does not surrender permanent custody, and custody cannot be transferred by the agency to others.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What are the agency’s core responsibilities regarding the child?",{"text":68,"@type":64},"The agency must provide approved substitute care, supervise the child, provide a visitation plan consistent with the child’s best interest, arrange necessary medical services, support education for school-age children, and gather needed educational, psychological, psychiatric, and social information.",{"name":70,"@type":61,"acceptedAnswer":71},"How can the temporary custody agreement be terminated or extended?",{"text":72,"@type":64},"The agreement can be terminated with a recommended three-day notice from the parent/guardian/custodian or the agency. If custody must continue longer, the parties seek approval for an extension, and the agency may petition juvenile court for court-ordered custody if disagreement remains.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},276941,1790194880,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,108,113,117,122],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":55,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":110,"show_sort_weight":111,"slug":112},17,"Forms",40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":115,"slug":116},18,30,"letters",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},21,"Paper Templates",5,"papers-templates",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":4,"slug":125},158,"General","general-158",{"code":4,"msg":82,"data":127},{"doc_id":79,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":114,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":139,"read_time":22},3573418547284,"https://eur-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Ohio Department of Children and Youth  \nAGREEMENT FOR TEMPORARY CUSTODY OF CHILD  \n\n| PART I: AGREEMENT FOR TEMPORARY CUSTODY OF CHILD\u003Cbr>Case Number:   |  |  |  |  |\n| --- | --- | --- | --- | --- |\n|   the Parent/Guardian/Custodian of   ,  \u003Cbr>(full name of parent/guardian/custodian) (child’s name) (D. O.B)\u003Cbr>living at   , have the authority to sign this agreement for\u003Cbr>(street address, city, state)\u003Cbr>temporary custody. My relationship to the above-named child is   The purpose of my\u003Cbr>(custodial role)\u003Cbr>signature is to request   to take temporary custody and control of the above-named child\u003Cbr>(agency name)\u003Cbr>for placement and planning supportive services for the following reasons:  \u003Cbr>_____________________________________________________________________________________________________________________________ ___ |  |  |  |  |\n| AS THE PARENT/GUARDIAN/CUSTODIAN, I AGREE TO THE FOLLOWING:\u003Cbr>1. Be financially responsible for the following support and health care during the term of this agreement:  \u003Cbr>2. Visit with the child as follows:  \u003Cbr>3. Notify the Agency within 24 hours of any changes in address or telephone number. |  |  |  |  |\n| THE AGENCY AGREES TO: 1) Provide care for the children in an approved substitute care setting and supervise the child. 2) Provide a plan for visitation between the parent/guardian/custodian and the child, consistent with the best interest of the child. 3) Notify the parent/guardian/ custodian in writing of its intention to terminate this agreement.\u003Cbr>THE AGENCY WILL: 1) Arrange and consent to all medical services necessary for the child. Parents will be informed of all medical care provided during this agreement. In emergency situations, the agency will arrange for medical care and notify the parent(s) as soon as possible. 2) Arrange for the education of school age children. 3) Gather any needed educational, psychological, psychiatric and social information. 4) Give permission for the child to travel within or outside the State of Ohio as necessary for vacation, school, church and other events in the best interest of the child.\u003Cbr>RELEASE OF INFORMATION: The Agency agrees that information regarding this voluntary agreement and information obtained about the child and family will only be released when it is deemed necessary and in the best interest of the child 's health, education and welfare. |  |  |  |  |\n| AGREEMENT PERIOD: This agreement will be effective from   to   and may be terminated upon a recommended three-day notice from the parent/guardian/custodian or the Agency. If it is necessary for the child to remain in custody longer than the above agreement period, the agency and the parent/guardian/custodian will seek the approval/of the parent/guardian/custodian and of the juvenile court for an extension of the temporary custody agreement. If the Agency feels continued custody is necessary, despite the parent/guardian/custodian 's disagreement, the Agency may file a petition with juvenile court requesting court-ordered custody. |  |  |  |  |\n| I, the parent/guardian/custodian, authorize the Agency to assume temporary custody of the child. Signature on this agreement does not in any way mean I am surrendering permanent custody of this child; nor can custody be transferred by the agency to anyone else. I have read this agreement, or it was read to me before I signed it. I was given the opportunity to ask questions concerning this agreement and those questions were fully answered to my satisfaction. I understand, authorize, and agree to the terms of this agreement. I am signing this agreement voluntarily. |  |  |  |  |\n| Witness | Date | Signature of Parent/Guardian/Custodian |  | Date |\n| Witness | Date | Signature of Parent/Guardian/Custodian |  | Date |\n| I, the Agency representative authorized pursuant to the Ohio Revised Code Sections 5103.03 and 5103.15 to accept the temporary custody of children, accept temporary custody of the child(ren) named above , according to the term","cbCaig9YC1RsvkIZ","https://ap.wps.com/l/cbCaig9YC1RsvkIZ","pdf",160168,"English","# Part I: Agreement for Temporary Custody of Child\n## Parent/Guardian/Custodian statements and responsibilities\n## Agency agreement and agency will\n## Release of information\n## Agreement period and extensions\n## Signatures and witnesses\n# Part II: Termination of Agreement for Temporary Custody of Child\n## Reason for termination and signatures\n# Part III: Agreement for Extension of Temporary Custody of Child\n## Original and additional extension details\n## Agreement extension period\n## Signatures and witnesses","[{\"question\":\"What authorization does the parent/guardian/custodian provide in Part I?\",\"answer\":\"The parent/guardian/custodian authorizes the agency to assume temporary custody. Signing does not surrender permanent custody, and custody cannot be transferred by the agency to others.\"},{\"question\":\"What are the agency’s core responsibilities regarding the child?\",\"answer\":\"The agency must provide approved substitute care, supervise the child, provide a visitation plan consistent with the child’s best interest, arrange necessary medical services, support education for school-age children, and gather needed educational, psychological, psychiatric, and social information.\"},{\"question\":\"How can the temporary custody agreement be terminated or extended?\",\"answer\":\"The agreement can be terminated with a recommended three-day notice from the parent/guardian/custodian or the agency. If custody must continue longer, the parties seek approval for an extension, and the agency may petition juvenile court for court-ordered custody if disagreement remains.\"}]","Agreement for Temporary Custody of Child | PDF",1789496469]