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Safe Harbor Family Services, Inc.

Helping California Families through the Foster Care process

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Contact Us

2937 Veneman Avenue
Ste B250
Modesto, CA 95356
(209) 491-5400

Forms

Here are some forms that our foster parents sometimes need, in downloadable PDF format. Just right-click the link and select “Save Target As” to save the form to your computer.

Below the forms is a downloadable listing of doctors and dentists in Stanislaus County who accept Medi-Cal. We update these about once a year to ensure you have access to the most current information available. But ask us for suggestions as well – our foster parents regularly tell us about great resources they’ve found, and we’re happy to pass their recommendations on.

  • Cash Resources log
  • Centrally Stored Medication Record
  • Clothing Inventory
  • Contact Log
  • Dental Form
  • LIC508D Out-of-State Disclosure and Criminal Record Statement
  • Medical and Dental Log
  • Medication Log
  • Physical Exam form
  • Property and Valuables
  • Weight Record

MEDICAL providers who accept Medi-Cal
DENTAL providers who accept Medi-Cal

Here is a handy chart for knowing how often kids should be seen by the doctor. Infants need regular well-baby exams every 2, 3 or 6 months (see chart) until they are two years old. Children age 3 and over should have a dental check every 6 months.

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