Interest Form | Yakima Valley Farm Workers Clinic

Submit a foster care interest form.

Make a difference in a young person’s life today. To ask questions, or for more information about becoming a foster parent, complete the form below and a foster care team member will contact you.

Name * Required
First Last
Date of Birth - must be mm/dd/yyyy format * Required
Date Format: MM slash DD slash YYYY
Phone * Required
Email * Required
ZIP Code
Number of people living in household
Gross household annual income?
Questions or comments
Phone
This field is for validation purposes and should be left unchanged.

Thank you for your interest in the Behavioral Health Services (BHS) Therapeutic Foster Care program. For immediate assistance, call (509) 453-1344. If you would like someone to contact you, please fill out the form on this page and one of our foster care team members will contact you shortly.