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Report of Suspected Abuse and Neglect

About this Form

Form number: 335-44

Audience:  Contractors, MCPS Staff, Volunteers

Last revised: August 2018

INSTRUCTIONS: An oral report must be made immediately to Child Welfare Services, Montgomery County Department of Health and Human Services (DHHS), (commonly known as Child Protective Services (CPS)), at 240-777-4417. For vulnerable adults, call Adult Protective Services (APS), at 240-777-3000. If this is an emergency, call the Montgomery County Police Department (MCPD), at 911 or 301-279-8000 immediately. Complete and submit this written report within 48 hours.

IF THERE IS DOUBT ABOUT WHETHER TO REPORT ABUSE OR NEGLECT, ALWAYS ERR IN FAVOR OF MAKING THE REPORT.

MCPS employees, contractors, or volunteers may not interrogate or collect written statements from any alleged victim, witness, or offender.

Adobe PDF Report of Suspected Abuse and Neglect444 KEnglish
Adobe PDF Denuncia de Sospecha de Abuso y Negligencia449 KSpanish
Adobe PDF Rapport de Cas Présumé de Maltraitance et de Négligence455 KFrench
Adobe PDF Báo Cáo Nghi Ngờ Bạo Hành và Bỏ Bê522 KVietnamese
Adobe PDF 舉報疑似虐待和忽視的事件665 KChinese
Adobe PDF 의심되는 아동 학대와 방치 신고서482 KKorean
Adobe PDF የተጠረጠረን በደል እና ቸል የመባል/ተገቢውን እንክብካቤን ያለማግኘት ሁኔታ ሪፖርት468 KAmharic

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