Intake Form

Office of the Child and Family Ombudsman Request for Assistance

Thank you for contacting the Office of the Child and Family Ombdusman.

We are an independent, impartial, and confidential resource to Montana citizens who are concerned about a child or family involved in the child protection system.

If you would like OCFO to review a case, please fill out the intake form below.

Please note the (R) indicates required information. If the system will not allow you to submit your Request for Assistance, it is likely there is a section that needs information.

* Required

Name*

Required

Email*

Required

Phone*

Required

Full Mailing Address*

Required

What is your age range?

How would you describe yourself?

African American or Black

American Indian or Alaskan Native

Asian American

Native Hawaiian or Pacific Islander

Caucasian

Hispanic or Latino

Multiracial

Other

Date of Birth

Who is the child/children? Please include full name and Date of Birth*

Required

Who is the responsible adult where the child lives?

Does the Child have an attorney, CASA or GAL? If so who?

Who is the Child's Mother and Father?

Who is the Family's Child Protection Specialist?*

Required

Please Describe your reason for requesting Ombudsman Assistance:*

Required

Describe how you believe the Ombudsman can help you:*

Required

Please tell us everything you have already done about this concern (Who from CFSD have you contacted?)*

Required

What would you like to see happen for this child or family?*

Required

How did you hear about OCFO?

Briefly describe the problem

Note: You might have to click "submit" twice.

Please call our hotline at 1-844-252-4453 or email DOJOMBUDSMAN@MT.gov with any questions you may have or if you need any help completing the form.