Get Suspected Child Abuse / Neglect Report Form

Filing a Suspected Child Abuse / Neglect Report Form online requires careful attention to detail to ensure that all necessary information is documented accurately. This guide will provide you with clear, step-by-step instructions to help you complete the form effectively.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by entering your name, title, telephone number, and email address in the section designated for the notifying person. Ensure that all information is accurate, as it is crucial for follow-up communication.
3. Fill in the date and time when the report is being made, providing an official record of your notification.
4. Indicate the name and title of the school principal or designated agent to whom the report is being made. This is important for ensuring that your report is directed to the correct individual.
5. Answer the question regarding whether you contacted the Department of Health and Human Services (DHHS) independently by marking 'Yes' or 'No'.
6. Provide the name of the student who is the subject of the report, along with their birth date, sex, grade, and any known history of abuse or neglect.
7. Enter the names of the parent or guardian(s) of the student, along with their address, home telephone number, and work telephone number to ensure proper communication.
8. List any siblings of the student, as their information may also be relevant to the report.
9. In the section designated for statements or indicators leading to the suspicion of abuse or neglect, include a detailed description of the information that led you to make this report, including dates, times, locations, names of alleged abusers, and their relationship to the student.
10. If applicable, list any photographs taken or materials collected related to the report.
11. Document any actions taken by school personnel, including dates, times, and the names of those involved.
12. Complete the confirmation section by having the principal or designated agent fill in their name, the agency contacted, the name and title of the agency contact, the date and time of the telephone report, and details of any report copies sent.
13. Require the principal or designated agent to sign and date the report to confirm its submission.
14. As the notifying person, acknowledge receipt of confirmation by signing and dating the acknowledgment section before returning it to the principal or designated agent.
15. Finally, save your changes, download, print, or share the completed form as necessary for your records and for those of the school.

Ensure you fill out and submit the SUSPECTED CHILD ABUSE / NEGLECT REPORT FORM online to help protect children in need.