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Fostering Community's Weighted Blanket Request Form
Weighted Blankets are not recommended for use for children age 3 and under or for use with extremely weak individuals.
Fostering Community and all service providers shall not be liable for any damages that result from the use of Weighted Blankets.
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Email
*
Your email
Foster Parent's Name
*
Your answer
Phone Number
*
Your answer
Home Development Worker's name
Your answer
Form completed by
Your answer
PLEASE FILL OUT A SEPARATE FORM FOR EACH CHILD
Child's Name
*
Your answer
Child's Gender
Your answer
Child's Age
Your answer
Child's Height & Weight
Your answer
Favorite Color & Character
Your answer
Child's Caseworker
Your answer
If your child is working with an OT, please consult with them on size and weight for your childs blanket. If you have an OT recommendation, please let us know in the spaces below.
Your answer
A copy of your responses will be emailed to the address you provided.
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