Telios Law's Mandatory Reporting Form

Most people know that if there is an allegation of child abuse, a report to the authorities needs to be made, but may be unsure of how to do it. Here is a template form that may help.

Download Your Mandatory Reporting Form Here


We have also included some points to consider, related to the form:

  • It’s appropriate to have people in the organization report first to their supervisor or to a designated Child Safety Coordinator. Remember, that does not fulfill their statutory reporting obligations. They (perhaps with their supervisor) still need to report.
  • Sometimes, leaders are not sure if they need to report, or how much to say. If this is the case, they should promptly contact their attorney. Remember, most states require very prompt reporting.
  • In situations where people getting a report of abuse may not be mandatory reporters, the organization’s policy should still lean heavily towards reporting all abuse. When in doubt, report.
  • The Reporter will be expected to provide full information, but this will be kept confidential.
  • It’s generally best for the “Reason for Report” to be very succinct while still being clear about the key issue (i.e. type of abuse). If the agency wants more detailed information, it can ask for it. Not volunteering too much sensitive information can help reduce any potential liability for the organization. In many cases, Child Protectives Services or law enforcement will not take further action, and it’s best if documentation in the file is clear but not extensive.
  • If the Alleged Victim is now a minor, the child’s personal information will need to be provided if it is known. When an Alleged Victim is now an adult, it is better to get permission before disclosing personal information. If the agency wants to talk to the Alleged Victim, one can always go back and ask.
  • Typically, a Report will provide all the personal information available on the Alleged Offender.
  • It is important to document where Reports were made: to which agency, within the organization or not, and the name of the persons reported to. Dates and times are helpful to create good records. If there are multiple contacts made during the attempt to report, these can be documented and attached as a second sheet.
  • Records of reporting child abuse should be maintained permanently.
  • Reporting can be tricky, so an organization may want to work with its attorney or even have the attorney make the Report.

Because of the generality of the information on this site, it may not apply to a given place, time, or set of facts. It is not intended to be legal advice, and should not be acted upon without specific legal advice based on particular situations