Florida DCF Form 5339: Consent, Court Order, and Reviews

Florida DCF Form 5339 is the Medical Report a prescribing physician or psychiatric nurse must complete before a child in Department of Children and Families custody can be given psychotropic medication. The six-page form, officially titled “CF-FSP 5339, Medical Report for Prescribing Psychotropic Medication to a Child in Out-of-Home Care,” documents the diagnosis, the proposed drug, its risks, and why alternatives won’t work, giving a judge the clinical basis to authorize treatment under Florida Statute 39.407. The prescriber fills it out, the case manager files it, and the medication then proceeds under either parental consent or a court order.

Where To Get the Form

You can download Form 5339 from the DCF forms library at myflfamilies.com/forms.¹ Case managers working a dependency case can also request copies through their regional DCF office. The Florida Agency for Health Care Administration will accept either the full six-page form or just Sections 4 and 5 on their own, provided the medication order is written into the blank space at the end of Section 4.

What the Form Must Document

Form 5339 collects the clinical information a judge needs to decide whether the medication serves the child’s best interests. Florida Statute 39.407(3)(c) sets out what the signed report must contain.² Every section needs to be filled in:

The child’s specific psychiatric diagnosis and the target symptoms the medication is meant to treat.
The drug name, dosage, and route of administration (oral, injection, and so on).
Recognized side effects, contraindications, drug-interaction precautions, and the risks of stopping the medication.
The monitoring plan, including any required lab work such as blood tests.
Non-pharmacological treatments that were tried or considered, such as behavioral therapy or counseling, and why medication is now the better option.
How long the prescriber expects the child will need the medication.
Confirmation that the treatment was explained to the child, when age-appropriate, and to the caregiver.²

The form also asks for recommendations on other services, such as behavioral health treatment, counseling, or medical care, that should accompany the medication. Leaving fields blank gives the judge a reason to delay or deny authorization, so treat every item as mandatory.

Who Signs It and Who Files It

The prescribing physician or psychiatric nurse completes the clinical sections and signs the form. No one else can substitute. Case managers, child protective investigators, caregivers, and residential facility staff are all prohibited from consenting to or signing off on psychotropic medication for a child in out-of-home care.³

Once the prescriber hands over the completed form, responsibility shifts to the case manager. The case manager must upload the Medical Report into the Florida Safe Families Network within three business days of receiving it.⁴ The case manager also distributes the form to the court, to the child’s Guardian ad Litem, and to the parents or legal guardians. When court authorization is needed, the case manager coordinates with Children’s Legal Services to file the motion.

Consent First, Court Order If Not

The starting point is always parental consent. Before a child in DCF custody is given psychotropic medication, the prescriber must try to obtain express and informed consent from the child’s parent or legal guardian.² DCF must take steps to involve the parent in the consultation with the prescriber. If the parent consents, no court order is needed for that medication, though DCF still files the Medical Report and keeps the court informed.

Court authorization becomes necessary when the parent declines to consent, cannot be located, or has had parental rights terminated. DCF then files a motion supported by two documents: a written report describing the department’s efforts to obtain parental consent, and the prescriber’s signed Medical Report. The motion and attachments go to the court, the Guardian ad Litem, and all parties.²

If any party objects, the court must hold a hearing “as soon as possible” before authorizing or continuing the medication. The statute does not fix a specific number of days for this hearing in the standard process; the judge sets it based on urgency and the court calendar. At the hearing the judge reviews the Medical Report, weighs the severity of the child’s symptoms against the drug’s risks, and hears from legal representatives for any party who wants to challenge or support the prescription.

If a parent whose rights have not been terminated later agrees to the medication, the court-authorization requirement drops away for that drug. DCF is still expected to keep the parent involved in decisions.

Starting Medication Before the Court Order

Sometimes a child needs medication immediately. Florida law provides two emergency pathways.

The first applies when the child was already taking a prescribed psychotropic medication at the time DCF removed them from the home. If parental authorization to continue cannot be obtained, DCF may take possession of the remaining medication and keep administering it until the shelter hearing, as long as the prescription is current and in its original container. The department must notify the parent as soon as possible and document why authorization wasn’t obtained up front.²

The second pathway covers new prescriptions. If the prescriber certifies that delaying the medication would “more likely than not cause significant harm” to the child, the medication can start before a court order issues. The Medical Report must spell out the specific reasons for potential harm and how severe it could be. DCF then has three working days to submit a motion and the Medical Report to the court, the Guardian ad Litem, and all other parties. The department must seek a court order at the next regularly scheduled hearing or within 30 days of the prescription date, whichever comes first. If any party objects, the court must hold a hearing within seven days.² Hospitals, crisis stabilization units, and statewide inpatient psychiatric programs may also begin medication before a court order, but DCF must still seek authorization within three working days of the first dose.

After Authorization: Reviews and Updates

A court order or parental consent starts the clock on ongoing monitoring. The case manager is responsible for making sure any lab tests or follow-up medical evaluations required by the prescriber actually get done. Results go into the child’s Resource Record and are shared with Children’s Legal Services, all parties, and the prescribing physician or psychiatric nurse.⁵

At every subsequent judicial review hearing, DCF must fully update the court on the child’s medical and behavioral status and provide copies of all pertinent medical records generated since the last hearing, including an updated Medical Report.⁵ This is where the reauthorization cycle lives: the court revisits the medication at each review, and the prescriber must prepare a fresh Form 5339 so the judge has current clinical information.

Certain changes trigger a new submission outside the regular review schedule. A new Form 5339 is required whenever the prescriber changes the medication or makes a significant dosage adjustment, when the child moves to a different placement, or when a different physician or psychiatric nurse takes over prescribing duties.⁶ A stale report tied to the wrong drug, dose, or prescriber creates dangerous gaps in a child’s care.

If a Parent Withdraws Consent

A parent who previously agreed to medication can change their mind. When that happens, the prescriber must record the parent’s decision, along with any reason given, directly in the Medical Report.³ If the prescriber still considers the medication medically necessary, the case manager obtains a completed Medical Report and DCF can seek court authorization to continue. From that point the process mirrors the standard court track: motion, distribution to all parties, and a hearing if anyone objects.

The prescriber may also determine that a parent or legal guardian is unable to provide express and informed consent, for example because of incapacity or an inability to understand the treatment. The basis for that determination must be documented in the Medical Report, and court authorization is then pursued.

Avoiding Common Delays

The most common reason a Medical Report stalls in court is thin documentation. Judges want to see that the prescriber seriously weighed alternatives before writing a prescription. A one-line note that therapy wasn’t effective is far less persuasive than a paragraph explaining which therapeutic approaches were tried, over what timeframe, how the child responded, and why medication is now the appropriate next step.

Side-effect documentation is another area where prescribers sometimes cut corners. The statute requires recognized side effects, risks, contraindications, and drug-interaction precautions, not just the top three from a package insert.² The form must also address what happens if the medication is stopped abruptly, which matters because placement changes and supply interruptions happen in the foster care system.

Case managers should not wait on the prescriber’s own timeline. The three-business-day FSFN upload window starts when the case manager receives the document, and missing it creates compliance problems that surface at judicial review. Confirming a handoff timeline with the prescriber’s office in advance saves trouble on both sides.

1
Florida Agency for Health Care Administration. Behavioral Health Medication Management Resources
2
The Florida Legislature. Florida Statutes Section 39.407
3
Legal Information Institute. Florida Admin Code R 65C-35.007 – Authority to Provide Psychotropic Medications to Children in Out-of-Home Care
4
Legal Information Institute. Florida Admin Code R 65C-35.013 – Medical Report
5
Legal Information Institute. Florida Admin Code R 65C-35.011 – Medication Monitoring
6
Florida Administrative Rules, Law, Code, Register. Definitions – 65C-35.001