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Care and placement plan

This cover note verifies that the care and placement plan for the child/young person named below has been discussed and read by the carer and the young person (if age-appropriate), and that both have been provided with a copy of the agreed plan.

By signing below, you confirm that you have read, agreed to, and received a copy of this care and placement plan.

Child/young person's name

Is the young person completing this acknowledgement? (Only if age-appropriate)

How many carers are signing?

Full legal name

Applicant 1

Signature