• Child-Focused Care Application

    Oklahoma Baptist Homes for Children

  • This application is for CHILDREN AGES 6-17 needing placement.

    If you are a single mother with children, please use the Family Focused Care Initial Application.

    Currently, OBHC can only accept children from Oklahoma, Arkansas, Kansas, Missouri and Texas.

  • Unfortunately, we cannot accept an application from you at this time.  OBHC can only accept children into care from Oklahoma, Arkansas, Kansas, Missouri and Texas.

  • General Information

  • Location Preference

    By checking your placement location preference below we will know how to best direct your application.

    Please do not submit an application to multiple locations. If you select "No Location Preference/First Available," your application will automatically be routed to both locations accepting your child's gender.

  • Which location would you prefer?*
  • Relationship to Child*

  • Format: (000) 000-0000.

  • Legal Custody/Guardian Information
    Who has legal custody of the child?

  • Format: (000) 000-0000.

  • Child Information

    Please note, beginning with this section, all further requested information is about the child, not the person filling out the application.

  • Date of Birth*
     - -
  • Child Gender*
  • Has the child experienced any of the following? (Please select all that apply)*

  • Medical Information

  • Does the child have any physical limitations?*

  • Aggression/Violence Tendencies

  • Is child verbally or physically aggressive?*
  • Has the aggression resulted in a physical confrontation or injury to another person?*
  • Were there weapons involved?*
  • Has the child been involved with law enforcement or juvenile?*
  • Please check any that child has been involved with:*

  • Drugs, Alcohol and Tobacco Usage

  • Does the child use substances?*
  • If yes, what types? (Check all that apply.)
  • Has the child ever been suspended or legally charged for possession or distribution of a substance?*

  • Behavioral Issues

  • Has the child ever run away or left home without permission?*
  • Does the child steal? *
  • Sexual Activities: (Check any that apply.)*

  • Psychological History

  • Emotional Issues

  • Does child fail to show shame or guilt for his/her negative behavior?*

  • Suicidal Thoughts

  • Has the child made suicidal comments or threats?*
  • Has the child attempted suicide?*
  • Has the child ever intentionally hurt themselves? (Ex: cutting, head banging, etc.)*
  • Has child been seen by a professional counselor?*
  • Has the child ever received inpatient health treatment?*
  • Does the child experience hallucinations/delusions?*

  • Educational History

  • Has the child failed any grade?*
  • Does the child have an Individualized Education Plan (IEP) for Specialized Educational Services?*
  • Is there a problem with school attendance?*
  • Has the child ever been placed in detention, suspended or expelled?*

  • Trauma, Grief/Loss

  • What types of trauma has this child experienced? (Check all that apply.)*

  • Notification Preference

  • Once your application is received and we have had the opportunity to review it, the campus will give you an initial contact with information. This is how we keep you informed of the process. Please indicate below the best way for us to contact you with the information regarding this application.

  • Preference*
  • Follow-Up Contact Preference
  • Should be Empty: