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Getting Started


Name: (required)
Address: (required)
City: (required)
State: (required)
Zip Code: (required)
Phone: (required)
E-mail address: (required)

Best way to contact you?: Email
Phone

Ethnicity? African American
Caucasian
Hispanic
Other

How did you hear about
the Heart Gallery:

Interested in one of our
Heart Gallery Children?
Yes   No
If yes list name(s)/
Date(s) of birth of child(ren):
If not available,
would you consider another
Heart Gallery Child(ren)?
Yes   No

Tell us about the child you are interested in adopting or fostering.
Gender: Male   Female
Age Range: 0-5   6-10   11-13  14-18
Sibling Group: Yes   No
Special Needs: Yes   No

Do you have a home study?: Yes   No
If yes, what agency?:

Comments:

   

Contact Us

Heart Gallery of Butler County
300 N. Fair Ave.
Hamilton, OH 45011
Phone 800-792-3854
Email:
Carrie.Jones@jfs.ohio.gov


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To get more information about Foster Care or Foster Care Adoptions, please fill out the:

 Prospective Parent Form

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