Consent By Non-Minor Dependent For Assignment Of Court Appointed Special Advocate (CASA) {SFUFC-CASA-B}

Rev. 12/2017 Page 1 of 2 *SFCASA is unable to collaborate with a Non-Minor Dependent (NMD) if at a minimum the NMD does not consent to access of the 223Juvenile Case File224 as defined by CRC, Rule 5.552 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Sate Bar Number, and Address) TELEPHONE NO: EMAIL ADDRESS (Optional) : FOR COURT USE ONLY Superior Court of California , County of San Francisco Juvenile Justice Center 375 Woodside Avenue, Room 101, San Francisco, CA 94127 Civic Center Courthouse 400 McAllister Street, Room 402, San Francisco, CA 94102 CASE NAME: CONSENT BY NON - MINOR DEPENDENT (NMD) FOR ASSIGNMENT OF COURT APPOINTED SPECIAL ADVOCATE (CASA) AND AUTHORIZATION TO SHARE INFORMATION PETITION NUMBER: 1. I, American LegalNet, Inc. www.FormsWorkFlow.com Rev. 12/2017 Page 2 of 2 *SFCASA is unable to collaborate with a Non-Minor Dependent (NMD) if at a minimum the NMD does not consent to access of the 223Juvenile Case File224 as defined by CRC, Rule 5.552 SFCASA PROGRAM GRIEVANCE POLICY EVERY EFFORT SHOULD BE MADE TO SOLVE PROBLEMS COOPERATIVELY AND INFORMALLY BEFORE PRESENTING THEM AS A FORMAL GRIEVANCE. WE ENCOURAGE ANYONE TO CONTACT THE SFCASA OFFICE AND ASK TO SPEAK WITH THE PROGRAM DIRECTOR (OR A MEMBER OF THE STAFF AUTHORIZED TO SPEAK ON THEIR BEHALF) TO DISCUSS ANY CONCERNS. SHOULD INFORMAL EFFORTS FAIL, THE FOLLOWING POLICY IS SET FORTH IN ORDER TO PROVIDE AN OUTLET FOR COMPLAINTS AND SYSTEMATIC MEANS TO RESOLVE GRIEVANCES. IF THE GRIEVANCE CONCERNS A CASA VOLUNTEER OR STAFF MEMBER, PLEASE SEND A LETTER, ALONG WITH SUPPORTING DOCUMENTS TO: SFCASA EXECUTIVE DIRECTOR 2535 MISSION STREET SAN FRANCISCO, CA 94110 ONCE RECEIVED THE MATTER SHALL BE ASSIGNED TO A STAFF MEMBER AS APPROPRIATE. THE EXECUTIVE DIRECTOR WILL HAVE FINAL SAY IN THE MATTER. DOCUMENTATION OF ANY GRIEVANCE FILED AGAINST A VOLUNTEER SHALL BE RETAINED IN THE VOLUNTEER222S FILE. IF THE GRIEVANCE PERTAINS TO THE EXECUTIVE DIRECTOR, PLEASE SEND A LETTER, ALONG WITH SUPPORTING DOCUMENTS TO: SFCASA BOARD PRESIDENT 2535 MISSION STREET SAN FRANCISCO, CA 94110 ONCE RECEIVED THE MATTER SHALL BE REVIEWED BY THE BOARD PRESIDENT. THE BOARD PRESIDENT SHALL HAVE FINAL SAY IN THE MATTER. American LegalNet, Inc. www.FormsWorkFlow.com