This form should be completed after a Mobile Response Team provides an in-person response, and to provide the details of that response to the County of Jurisdiction and/or
Statewide Hotline, and to
CDSS. Please note: this report, and its content, should
not be attached to or included in a case plan/court report. The purpose of this form is to ensure linkage to ongoing supportive services.
The form should take no more than 15 minutes to be completed. For instruction on how to fill out this report, please refer to the
FURS Summary Report Guide. For additional questions, please contact
FURS@dss.ca.gov.