Child Protection Program Forms
- Department of Justice Forms
- Department of Social Services Forms
- Office of Emergency Services Forms
- Reference Material
These forms are for use by government agencies and certain individuals to report information required by law in child abuse cases. If you suspect a case of child abuse in your neighborhood, you should contact your county child welfare agency or your local police department or sheriff's office.
Department of Justice (DOJ) Forms
If you have questions regarding the use of the forms, contact the DOJ Child Protection Program.
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Child Abuse Investigation Report Form.
For use by specified investigating agencies to report to the state Department of Justice.
- Form SS 8583
[PDF 44 kb / 1 pg] - Instructions [PDF 48 kb / 1 pg]
- Guide for Reporting Child Abuse [PDF 716 kb / 24 pg]
- Form SS 8583
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Suspected Child Abuse Report Form.
For use by mandated reporters to notify a reporting agency (local law enforcement, county probation or county welfare department) about suspected cases of child abuse. Also may be used to cross-report to another reporting agency.
- Form SS 8572 [PDF 61 kb / 1 pg]
- Instructions [PDF 71 kb / 1 pg]
- Form SS 8572
- Live Scan Applicant Forms. For use by authorized agencies and nonprofit groups to request criminal background checks for prospective child placement and employment purposes. More information available from the Fingerprint Submissions Program.
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Child Abuse Central Index Self Inquiry Form.
For use by citizens who want to request a self inquiry of the Child Abuse Central Index.
- Child Abuse Central Index Self Inquiry Form [PDF 113 kb / 1 pg]
- Child Abuse Central Index Self Inquiry Form
Department of Social Services (DSS) Forms
The Department of Social Services has developed and maintains these forms pertaining to child abuse background checks for licensed childcare facilities. If you have questions or need more information, visit the DSS website.
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Child Abuse Central Index Check For County/State-Licensed Facilities Forms.
This form is supplied by the Department of Social Services for licensing and/or foster care purposes. See DSS On-Line Forms and Publications - "L Forms" to download by form number.
- Form LIC 198 [PDF 90 kb / 1 pg]
- Form LIC 198A [PDF 37 kb / 1 pg]
- Other forms on the DSS website
- Form LIC 198
Office of Emergency Services Forms
The forms below pertain to child abuse. For questions about the OES forms, contact the Office of Emergency Services, Law Enforcement and Victim Services Division.
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Medical Report: Suspected Child Physical Abuse and Neglect Examination.
Used by physicians for reporting evidence of child sexual abuse. Form should be used in lieu of DOJ Form 900 for cases of chronic sexual abuse of minors.
- Form OES 900 [PDF 140 kb / 8 pg]
- Instructions [PDF 53 kb / 8 pg]
- Protocols [PDF 447 kb / 122 pg]
- Form OES 900
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Suspicious Injury Report.
- Form OES 920 [PDF 15 kb / 1 pg]
- Instructions [PDF 16 kb / 1 pg]
- Form OES 920
Reference Materials
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