Get Child Abuse/neglect Form (pdf) - Mass.gov - Mass

Filling out the Child Abuse/Neglect Form is an important step for mandated reporters to ensure the safety and well-being of children. This guide provides clear and supportive instructions on how to properly complete the form to report suspected abuse or neglect.

Follow the steps to accurately fill out the Child Abuse/Neglect Form.

1. Click the ‘Get Form’ button to download the form. Once you obtain the form, open it in an appropriate PDF editor.
2. Begin by completing the section titled 'Children Reported.' Provide the names and current locations of the children involved, along with their sex and date of birth or age.
3. Next, fill out the details for 'Parent or Guardian 1.' Include their first, last, and middle names, current address, phone number, and date of birth.
4. Proceed to the 'Parent or Guardian 2' section and provide similar information as required for the first guardian.
5. In the 'Reporter / Report' section, indicate the date of the report, the nature of the report (mandatory or voluntary), and your name and address. Make sure to include your phone number and state whether you informed the caretaker about the report.
6. Describe the nature and extent of the injury, abuse, or neglect. Be comprehensive and include any prior incidents or additional concerns.
7. If applicable, provide the name(s) and contact information for individuals responsible for the abuse, as well as any relevant circumstances or timelines related to the reported incidents.
8. Indicate actions you have already taken to assist the child or ensure their safety.
9. If the report involves domestic violence, provide relevant information to help ensure safe contact with the family.
10. Finally, add any information about the family's strengths that might help the Department of Children and Families (DCF) in their investigation.
11. Complete the form by signing your name in the designated area and reviewing all entries for accuracy.
12. Once finished, save the changes made to the form. You may then download, print, or share the completed form as necessary.

Take action today by completing the Child Abuse/Neglect Form online to help ensure the safety of children in your community.