Form S-19 PRS Referral - UC Portal

Services Provided to Unaccompanied Children

PRS Referral (Form S-19) - UC Portal

Post-Release Service (PRS) Referral (Form S-19)

OMB: 0970-0553

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Post-Release Services (PRS) Referral (Form S-19)

Shape8 Shape9 Shape10 Shape11 Shape12 Shape13 Shape1 Shape6 Shape7 Shape2 Shape5 Shape3 Shape4

auto-populated

system-generated

system-generated

system-generated

  • Level 1

  • Level 2

  • Level 3

auto-populated

auto-populated

auto-populated

auto-populated

auto-populated

auto-populated

auto-populated

auto-populated


Populates when “PRS-TVPRA” is selected

Shape24 Shape20 Shape19 Shape21 Shape16 Shape17 Shape18 Shape27 Shape26 Shape25 Shape22 Shape23 Shape15 Shape14

auto-populated

auto-populated

auto-populated

auto-populated

auto-populated

auto-populated

auto-populated

auto-populated

system-generated

system-generated

system-generated

system-generated

  • Victims of Trafficking (TVPRA)

  • American Disability Act (TVPRA)

  • Physical or Sexual Abuse by Caregiver (TVPRA)

  • Sponsor Risk (TVPRA)

  • 12 and Under Going to Non-Relative Sponsor (ORR Mandated)

  • Non-Relative Sponsor Multiple Sponsorship (ORR Mandated)

  • ORR Discretionary

  • RTC Placement

  • Medically Fragile

  • Pregnant

  • Parenting

  • Tender Age

  • Sibling Group

  • Related

Shape28

List of all home study providers



Populates when “PRS” is selected

Shape35 Shape34 Shape33 Shape32 Shape31 Shape29 Shape30

auto-populated

auto-populated

system-generated

system-generated

system-generated

  • 12 and Under Going to Non-Relative Sponsor - ORR Mandated Home Study

  • Non-Relative Sponsor Multiple Sponsorship - ORR Mandated Home Study

  • ORR Discretionary Home Study

  • UC Going to Non-Relative Sponsor - ORR Mandated No Home Study

  • Other - No Home Study

system-generated

Shape36

  • RTC Placement

  • Medically Fragile

  • Pregnant

  • Parenting

  • Tender Age

  • Sibling Group

  • Related








Populates when either “PRS-TVPRA” or “PRS” is selected

Shape37

system-generated


Shape39 Shape38



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorHerboldsheimer, Shannon (ACF)
File Modified0000-00-00
File Created2024-09-04

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