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How do I fill this out?
To fill out this form, start by providing the identifying information of the child(ren) and the person suspected of causing maltreatment. Ensure all fields are completed thoroughly, detailing the nature of the suspected abuse or neglect. Finally, include your information as the reporter and submit the form as instructed.

How to fill out the Report of Suspected Child Abuse or Neglect?
1
Provide the name and details of the child(ren).
2
Fill in the parent's or caretaker's information.
3
Include details about the person suspected of maltreatment.
4
Describe the nature and extent of the suspected abuse or neglect.
5
Complete your information as the reporter and sign.
Who needs the Report of Suspected Child Abuse or Neglect?
1
Parents or guardians reporting suspected abuse.
2
Teachers recognizing signs of neglect in students.
3
Healthcare professionals who suspect child maltreatment.
4
Social workers handling child welfare cases.
5
Community members wanting to ensure child safety.
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What are the important dates for this form in 2024 and 2025?
For the fiscal years 2024 and 2025, ensure that any reports made regarding suspected child abuse comply with ongoing policy updates. Review the North Dakota Department of Human Services announcements for deadlines and compliance updates. Significant dates will include policy changes and form updates, so stay informed.

What is the purpose of this form?
The purpose of this form is to provide a standardized method for reporting suspected child abuse or neglect. It enables individuals and mandated reporters to document detailed information concerning the potential maltreatment of a child. This structured approach helps facilitate timely intervention and support for affected children and families.

Tell me about this form and its components and fields line-by-line.

- 1. Child's Details: Includes the names and ages of the child or children whom the report concerns.
- 2. Parent/Caretaker Information: Captures the details of the parent or caretaker of the child.
- 3. Suspected Perpetrator: Information about the individual suspected of causing abuse or neglect.
- 4. Description of Abuse: Detailed account of the nature and extent of the suspected abuse or neglect.
- 5. Reporter Information: Details regarding the person reporting the suspected maltreatment.
What happens if I fail to submit this form?
Failing to submit this form may result in delayed intervention for at-risk children. Without proper reporting, suspected cases may go unaddressed, perpetuating harm. It is crucial to ensure timely and accurate submissions to protect children's welfare.
- Delayed Response: Failure to report may cause delays in necessary protective actions.
- Increased Risk: Children may remain in harmful environments if reports are not filed.
- Legal Consequences: Not reporting suspected abuse can lead to legal implications for mandated reporters.
How do I know when to use this form?

- 1. Abuse Observed: Use this form when you witness potential abuse first-hand.
- 2. Neglect Indicators: File this report if you recognize signs of neglect in a child.
- 3. Professional Obligations: Required for professionals like teachers or social workers who must report suspected abuse.
Frequently Asked Questions
What is the purpose of this form?
This form is designed to report suspected child abuse or neglect to the relevant authorities.
How do I fill out this form?
Provide accurate information about the child, the suspect, and details of the suspected maltreatment.
Can I edit this PDF on PrintFriendly?
Yes, you can easily upload and edit this PDF using our dedicated tools.
How do I submit this form?
You can submit the completed form online or via fax to the designated authorities.
Is it confidential to report suspected abuse?
Yes, your information will be kept confidential as per agency policies.
What happens after I submit the form?
The appropriate authorities will review your report and take necessary action.
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