State of Alabama
Unified Judicial System
Form JU–12B Rev. 6/13
LEGAL INFORMATION
(SOCIAL HISTORY SERIAL)
Court Case Number
IN THE JUVENILE COURT OF _________________________________________________ COUNTY, ALABAMA
(Name of County)
In the Matter of _______________________________________________________________________, a child
Part I PRIOR JUVENILE COURT RECORD:
Date Offense / Matter Disposition
Part II CHILD’S ATTITUDES TOWARD CURRENT OFFENSE AND HIS STATEMENT:
Part III COMPLAINANT’S (Victim’s) STATEMENT AND ATTITUDES TOWARD CURRENT OFFENSE:
Part IV PARENT’S ATTITUDES TOWARD OFFENSE:
Part V PARENT’S PRIOR POLICE RECORD:
_________________________________ _______________________________________________
Date Signature of Juvenile Probation Officer
(Name of Child)
State of Alabama
Unified Judicial System
Form JU-12C Rev. 6/13
SCHOOL INFORMATION
(SOCIAL HISTORY SERIAL)
Court Case Number
IN THE JUVENILE COURT OF ____________________________________________________________COUNTY, ALABAMA
(Name of County)
In the Matter of___________________________________________________________________________________, a child
Current School:____________________________________________________________________________________________
Schools Previously Attended:_________________________________________________________________________________
Grades Repeated (if applicable):______________________________________________________________________________
Present Grade: __________________ Test Given:______________________ Date
Results: ________________________ Given:_______________________
Functional Grade Level: ________________
Academic Record:
Record
Attached,
Report card,
etc.
Attendance: Required Days: ______________________________
Days Present: ________________________________
Excused Absences: ____________________________
Unexcused Absences: __________________________
Conduct Reports,
Behavior, Attitude
Towards School &
Persons in
Authority: _______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Extracurricular
Activities: _______________________________________________________________________________________________
_______________________________________________________________________________________________
School Officials
Contacted: _____________________________________________________________________________________________
_____________________________________________________________________________________________
Phone: ________________________________
___________________________________ _______________________________________________
Date Signature of School Official
___________________________________ _______________________________________________
Date Signature of Juvenile Probation Officer
Current Year Last Year
Subject 1 2 3 4 5 6 Yr. Subject 1 2 3 4 5 6 Yr.
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
6. 6.
(Name of Child)
State of Alabama
Unified Judicial System
Form JU – 12D Rev. 6/13
PROFILE OF CHILD
(SOCIAL HISTORY SERIAL)
Court Case Number
IN THE JUVENILE COURT OF ___________________________________________________________ COUNTY, ALABAMA
(Name of County)
In the Matter of ___________________________________________________________________________________, a child
A profile of the child should include comments about physical appearance; self-image (how the child sees
himself/herself); general attitude towards authority, parents, school and police; peer relationships; strengths, weaknesses,
and attributes the child has that could help him/her through problems; employment history (full-time and part-time);
interests, hobbies and activities; special placements (i.e., special education, foster homes, vocational rehabilitation, etc);
description of programs and adjustment, length of stay, reasons for removal; and other pertinent comments or analysis.
__________________________________ _____________________________________________
Date Signature of Juvenile Probation Officer
(Name of Child)
State of Alabama
Unified Judicial System
Form JU-12E Rev. 6/13
FAMILY–HOME INFORMATION
(SOCIAL HISTORY SERIAL)
Court Case Number
IN THE JUVENILE COURT OF _____________________________________________________________COUNTY, ALABAMA
(Name of County)
In the Matter of ____________________________________, a child Age: _________ Sibling Rank By Birth: ____________
Description of Home:
Family Information: Comment on all pertinent information about the child’s family, and income; parents’ marital status
and marital history; medical problems; recurring illnesses, mental or physical; family activities;
general relationships among parents, child, child’s siblings; attitude of parents toward offense; etc.
Other agencies working with family or individual member: (Past or present)
_________________________________ _________________________________________________________
Date Signature of Juvenile Probation Officer
(Name of Child)
State of Alabama
Unified Judicial System
Form JU–12F Rev. 6/13
MEDICAL INFORMATION
(SOCIAL HISTORY SERIAL)
Court Case Number
IN THE JUVENILE COURT OF _______________________________________________ COUNTY, ALABAMA
(Name of County)
In the Matter of _________________________________________________________________________, a child
Health History:
Physical History (List diseases, physical handicaps, or surgical history):
Last Physical Exam (date, doctor, results):
Name of Family Doctor: ____________________________ Hospital Plan: _______________________________
Office Address: __________________________________ Medicaid No.: _______________________________
________________________________________________
Phone: ______________________________
Psychiatric History:
Immunizations – Childhood Diseases:
Other Comments: (Immediate problems, current treatments, habits, diet and other factors detrimental to health, medical
complaints and problems)
_________________________________ ____________________________________________________
Date Signature of Probation Officer
(Name of Child)
State of Alabama
Unified Judicial System
Form JU-12G Rev. 6/13
SUMMARY – RECOMMENDATIONS
(SOCIAL HISTORY SERIAL)
Court Case Number
IN THE JUVENILE COURT OF ______________________________________________COUNTY, ALABAMA
In the Matter of _______________________________________________________________________, a child
Needs Assessment and Treatment Priorities (Specific areas or target behavior, i.e., cursing, constant fighting):
Recommendations:
Referral Resources That are Indicated:
Other Comments:
________________________________ ____________________________________________________
Date Signature of Juvenile Probation Officer
(Name of County)
(Name of Child)
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