Initial Report Forms

This section contains a template for initial report forms that can help staff share concerns related to child safety. The purpose of the initial report form is to report any potential child maltreatment, begin a child abuse response inquiry, and/or gathering initial information for further risk assessment of any incident.

Below you will find four (4) different report forms:

Child-to-Child report form is used to report suspected harmful/inappropriate incident(s) and/or maltreatment that may have occurred recently or in the near past between a child or children and/or youth under the age of 18.

Child-to-Child

Adult-to-Child report form is to report suspected harmful/inappropriate incident(s) and/or maltreatment of children and/or youth under the age of 18 by an adult.

Adult-to-Child

Historic Child-to-Child report form is used to report suspected harmful/inappropriate incident(s) and/or maltreatment that may have not occurred recently between a child or children and/or youth under the age of 18.

Historic Child-to-Child

Historic Adult-to-Child report form is used to report suspected harmful/inappropriate incident(s) and/or maltreatment that may have not occurred recently between a child or children and/or youth under the age of 18 by an adult.

Historic Adult-to-Child