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Child Welfare System Navigation Form
The Parents of Black Children Child Welfare Systems Navigator will provide support to families who need help navigating the child welfare system. The Systems Navigator will also provide capacity building workshops on how the child welfare system works. Details will be shared with you after you have completed the form. Please fill out this form in order to contact our Systems Navigator. We will do our best to get back to you within 3 business days. This form is considered confidential. No information in this form will be shared with anyone outside of the Parents of Black Children team without your consent.
Email
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First Name
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Last Name
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Phone Number
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What is the best way to contact you?
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Please select
Phone
Email
What region do you live in?
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York Region
Peel Region
Durham Region
Simcoe County
Halton Region
Muskoka Region
Other
If you selected "Other" please enter your region.
How old is/are your child(ren)?
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Please describe your situation/issues below in as much detail as possible to our Systems Navigator.
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On a scale of 1-5, how confident do you feel in being able to navigate the child welfare system?
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Please select
1
2
3
4
5
I agree that by signing this form Parents of Back Children can share this information with a trusted third party (e.g. a pro bono legal team) in order to support me in navigating the system. I understand that I can withdraw this consent verbally at any time.
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I agree
I consent to the information outlined in this submission being shared with Parents of Black Children internal committees, who can provide advice and information to support me. I understand that I can withdraw this consent verbally at any time.
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I agree
I understand that Parents of Black Children will never share my personal information or story in a public setting without my express consent. I understand that I can withdraw this consent verbally at any time.
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I agree
I consent to have this information, including personally identifying information, shared with the Parents of Black Children Systems Navigator.
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I agree
