Nebraska Revised Statute 43-1314.02
Chapter 43 Section 1314.02
Caregiver information form; development; provided to caregiver.
(1) The court shall provide a caregiver information form or directions on downloading such form from the Supreme Court Internet web site to the foster parent, preadoptive parent, guardian, or relative providing care for the child when giving notice of a court review described in section 43-1314. The form is to be dated and signed by the caregiver and shall, at a minimum, request the following:
(a) The child's name, age, and date of birth;
(b) The name of the caregiver, his or her telephone number and address, and whether the caregiver is a foster parent, preadoptive parent, guardian, or relative;
(c) How long the child has been in the caregiver's care;
(d) A current picture of the child;
(e) The current status of the child's medical, dental, and general physical condition;
(f) The current status of the child's emotional condition;
(g) The current status of the child's education;
(h) Whether or not the child is a special education student and the date of the last individualized educational plan;
(i) A brief description of the child's social skills and peer relationships;
(j) A brief description of the child's special interests and activities;
(k) A brief description of the child's reactions before, during, and after visits;
(l) Whether or not the child is receiving all necessary services;
(m) The date and place of each visit by the caseworker with the child;
(n) A description of the method by which the guardian ad litem has acquired information about the child; and
(o) Whether or not the caregiver can make a permanent commitment to the child if the child does not return home.
(2) A caregiver information form shall be developed by the Supreme Court. Such form shall be made a part of the record in each court that reviews the child's foster care proceedings.