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REPORT OF ACTUAL OR SUSPECTED CHILD ABUSE OR NEGLECT Michigan Department of Human Services Log # Was referral phoned to DHS? Yes No If yes, If no, contact the local DHS Office immediately 1. Date INSTRUCTIONS:.

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How to fill out the MI DHS-3200 online

The MI DHS-3200 form is a crucial document for reporting suspected child abuse or neglect in Michigan. This guide provides step-by-step instructions for completing the form online to ensure accuracy and compliance.

Follow the steps to complete the MI DHS-3200 online effectively.

  1. Click ‘Get Form’ button to obtain the MI DHS-3200 and open it in the editor.
  2. Begin by entering the date in the designated field. This should reflect the day you are filling out the form.
  3. Provide details for each child suspected of being abused or neglected. Enter their name, birth date, social security number, sex, and race. Use additional sheets if necessary.
  4. Input the mother's name, ensuring to include any substitute names as applicable. Provide relevant information regarding any disabilities that may necessitate accommodations.
  5. Enter the father's name in the same manner as the mother's, noting any pertinent details about disabilities as needed.
  6. Complete the address fields for the child or children, including street number and name, city, and county.
  7. Fill in the phone number for the household where the child resides.
  8. Identify the alleged perpetrator's name and indicate their relationship to the child or children.
  9. Specify who the children were living with when the abuse or neglect occurred.
  10. Complete the address section of where the abuse or neglect happened.
  11. Describe the injuries or conditions that led to suspicion of abuse or neglect, providing thorough details.
  12. Check the appropriate box to denote the source of referral, ensuring to select the correct professional group related to the report.
  13. Enter your name as the referring person, along with the name of your organization if applicable.
  14. Provide the address, city, state, and zip code for the referring person and their organization.
  15. Finish the form by reviewing all entries for accuracy. Once completed, you can save changes, download, print, or share the form as needed.

Complete your MI DHS-3200 form online now to ensure timely reporting.

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MI DHS-3200
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