What forms need to be completed?

Some standards have forms that are referenced in the Table of Evidence. You can find them in your MyCOA account or on COA’s website.

When a form is required, you can use the form provided or attach an existing form in lieu of this document, provided that it captures all of the information requested in the form.

Forms Description
Collaborative Relationships Profile This form is used to provide information about the adoption service providers you partner with in Convention cases. You will need to include contact information for each provider. You will also need to indicate what role each provider takes on when you work on Convention cases together (e.g., primary provider, supervised provider, or exempt provider). You will need to include information about domestic and foreign partners on this form.
Governing Body Profile This form is used to provide information about the members of your Governing Body/Advisory Group. This form is NA for individual practitioners seeking approval.
Employee Profile This form is used to provide information about employees who are involved in the provision of services in Convention cases.
Executive Verification Statement This form is used by your Executive Director and Governing Body Chair to disclose certain information, as required in the standards. This form must be notarized.
State Licensing and Regulatory Profile This form is used to provide information about the state licensing rules or other regulations that apply.


Private Organization Accreditation

Lutheran Social Services of New England is a high-performing nonprofit organization. LSS is a powerful difference maker and go-to resource, driving ourselves to constantly anticipate futures that are different from the past. For 140 years, LSS has been caring for people in need in New England.


Rochelle Haimes, ACSW

Volunteer Roles: Commissioner; Peer Reviewer; Standards Panel Member; Team Leader

Rochelle is a Consultant working with a variety of private organizations to become accredited. Her primary area of expertise is in facilitating the development of PQI systems and activities. Her previous experience with both small and large organizations is the cornerstone for her long-standing volunteer activities as a Peer reviewer and as a Team Leader.
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