Week 9 discussion crj

State of Alabama
Unified Judicial System

Form JU–12B Rev. 6/13

LEGAL INFORMATION
(SOCIAL HISTORY SERIAL)

Court Case Number

IN THE JUVENILE COURT OF _________________________________________________ COUNTY, ALABAMA

(Name of County)

In the Matter of _______________________________________________________________________, a child

Part I PRIOR JUVENILE COURT RECORD:

Date Offense / Matter Disposition

Part II CHILD’S ATTITUDES TOWARD CURRENT OFFENSE AND HIS STATEMENT:

Part III COMPLAINANT’S (Victim’s) STATEMENT AND ATTITUDES TOWARD CURRENT OFFENSE:

Part IV PARENT’S ATTITUDES TOWARD OFFENSE:

Part V PARENT’S PRIOR POLICE RECORD:

_________________________________ _______________________________________________
Date Signature of Juvenile Probation Officer

(Name of Child)

State of Alabama
Unified Judicial System

Form JU-12C Rev. 6/13

SCHOOL INFORMATION
(SOCIAL HISTORY SERIAL)

Court Case Number

IN THE JUVENILE COURT OF ____________________________________________________________COUNTY, ALABAMA
(Name of County)

In the Matter of___________________________________________________________________________________, a child

Current School:____________________________________________________________________________________________

Schools Previously Attended:_________________________________________________________________________________

Grades Repeated (if applicable):______________________________________________________________________________

Present Grade: __________________ Test Given:______________________ Date
Results: ________________________ Given:_______________________

Functional Grade Level: ________________

Academic Record:
Record
Attached,
Report card,
etc.

Attendance: Required Days: ______________________________
Days Present: ________________________________
Excused Absences: ____________________________
Unexcused Absences: __________________________

Conduct Reports,
Behavior, Attitude
Towards School &
Persons in
Authority: _______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Extracurricular
Activities: _______________________________________________________________________________________________
_______________________________________________________________________________________________

School Officials
Contacted: _____________________________________________________________________________________________
_____________________________________________________________________________________________

Phone: ________________________________

___________________________________ _______________________________________________
Date Signature of School Official

___________________________________ _______________________________________________
Date Signature of Juvenile Probation Officer

Current Year Last Year
Subject 1 2 3 4 5 6 Yr. Subject 1 2 3 4 5 6 Yr.

1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
6. 6.

(Name of Child)

State of Alabama
Unified Judicial System

Form JU – 12D Rev. 6/13

PROFILE OF CHILD
(SOCIAL HISTORY SERIAL)

Court Case Number

IN THE JUVENILE COURT OF ___________________________________________________________ COUNTY, ALABAMA

(Name of County)

In the Matter of ___________________________________________________________________________________, a child

A profile of the child should include comments about physical appearance; self-image (how the child sees
himself/herself); general attitude towards authority, parents, school and police; peer relationships; strengths, weaknesses,
and attributes the child has that could help him/her through problems; employment history (full-time and part-time);
interests, hobbies and activities; special placements (i.e., special education, foster homes, vocational rehabilitation, etc);
description of programs and adjustment, length of stay, reasons for removal; and other pertinent comments or analysis.

__________________________________ _____________________________________________
Date Signature of Juvenile Probation Officer

(Name of Child)

State of Alabama
Unified Judicial System

Form JU-12E Rev. 6/13

FAMILY–HOME INFORMATION
(SOCIAL HISTORY SERIAL)

Court Case Number

IN THE JUVENILE COURT OF _____________________________________________________________COUNTY, ALABAMA

(Name of County)

In the Matter of ____________________________________, a child Age: _________ Sibling Rank By Birth: ____________

Description of Home:

Family Information: Comment on all pertinent information about the child’s family, and income; parents’ marital status
and marital history; medical problems; recurring illnesses, mental or physical; family activities;
general relationships among parents, child, child’s siblings; attitude of parents toward offense; etc.

Other agencies working with family or individual member: (Past or present)

_________________________________ _________________________________________________________
Date Signature of Juvenile Probation Officer

(Name of Child)

State of Alabama
Unified Judicial System

Form JU–12F Rev. 6/13

MEDICAL INFORMATION
(SOCIAL HISTORY SERIAL)

Court Case Number

IN THE JUVENILE COURT OF _______________________________________________ COUNTY, ALABAMA

(Name of County)

In the Matter of _________________________________________________________________________, a child

Health History:

Physical History (List diseases, physical handicaps, or surgical history):

Last Physical Exam (date, doctor, results):

Name of Family Doctor: ____________________________ Hospital Plan: _______________________________

Office Address: __________________________________ Medicaid No.: _______________________________
________________________________________________

Phone: ______________________________

Psychiatric History:

Immunizations – Childhood Diseases:

Other Comments: (Immediate problems, current treatments, habits, diet and other factors detrimental to health, medical
complaints and problems)

_________________________________ ____________________________________________________
Date Signature of Probation Officer

(Name of Child)

State of Alabama
Unified Judicial System

Form JU-12G Rev. 6/13

SUMMARY – RECOMMENDATIONS
(SOCIAL HISTORY SERIAL)

Court Case Number

IN THE JUVENILE COURT OF ______________________________________________COUNTY, ALABAMA

In the Matter of _______________________________________________________________________, a child

Needs Assessment and Treatment Priorities (Specific areas or target behavior, i.e., cursing, constant fighting):

Recommendations:

Referral Resources That are Indicated:

Other Comments:

________________________________ ____________________________________________________
Date Signature of Juvenile Probation Officer

(Name of County)

(Name of Child)

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