Initial Qualification Form 

Please submit this form each time you'd like to begin the process of receiving services from With Love (even if you have the link to the Materials Request Form from a previous request!)


This form is simply to initiate services; the next steps email will include a link to provide details on the types of items needed and information about the children in your care.  

Upon completion, our support team will review your form to ensure that you meet With Love's qualifications for services and email you with the next steps, generally within 1-2 business days. 

Ensure you enter your email address correctly, as our Family Support Specialist will be contacting you via email.

Please complete the form only after the child is in your legal custody, as stated in DHS's placement letter.

If you encounter any issues or have any other questions, please contact support@withloveoregon.org.   

Sign in to Google to save your progress. Learn more
Email *
Resource Parent Name (First and Last) *
Phone Number *
What *county do you live in? *With Love serves Oregon & SW Washington counties listed below. If you are outside our scope we suggest Cloth + Foster (Vancouver) or Treehouse (Seattle).  *
Are you a resource parent (or an adoptive parent via foster care) with a child placed in your care under the age of 7? *
Is the child in your home now?
 *
Is this the first time requesting for this child?
 *
Has your family requested support from With Love Oregon before? *
Which provider type best describes you?  *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of With Love.

Does this form look suspicious? Report

Google Forms