All fields of this form must be completed. If a question does not apply to you, please write "N/A".


Case Information

Please indicate ALL the options you are able to schedule a visit. Please do not base this on preference. Put N/A if there are days where you have no availability.


Authorization to Exchange/Drop off or Pick Up Child

The parent the child lives with will complete this section

to pick up my children in lieu of myself. I understand that the parties I authorize will also be required to follow Arizonans for Children guidelines and rules regarding exchanges and visitations. I understand that they may be required by Arizonans for Children staff to show a driver’s license as proof of identification. Failure to provide identification may result in children not being released to that party.