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Report of Suspected Child Abuse/Neglect Form

  1. IF THIS IS AN EMERGENCY DIAL 911

    Please complete the online form below to report suspected abuse/neglect. All fields are mandatory even if the reply is "unknown" or "not applicable (n/a)". The use of profanity will cause the report submission to fail. Please be sure to provide your contact information if you feel the profanity is an essential part of your report and include a statement to that effect in the description of the nature and extent of the incident you are reporting.

  2. Reporter's Information

  3. Leave This Blank:

  4. This field is not part of the form submission.