After observations have lead you to the conclusion that there is a possibility of child abuse and neglect the following information will be needed 'in order to make a complete report. If all of the 'information is not available, please provide as much as possible. Referrals given without the name of the person making the referral may not be investigated.

Providers should be prepared to provide the following information including:

1. Parents first and last names.

2. Current address (DCFS can not investigate child abuse and neglect concerns without a valid address)

3. Current home telephone number.

4. Parent's place of employment and telephone number.

5. Children's names, dates of birth, sex and race.

6. Name of school the children attend. what grade they are in?

7. The time children go home from school, are they in an afterschool program?

8. Other relative's names addresses and phone numbers.

9. Names of others who have information about the family.

10. Reason the children are at risk and a description of the maltreatment, with as much detail as you can provide. (This is where records of observations could be critical.)

11. Your name, phone number, mailing address, and relationship to the family.

12. What you feel should be done by the department.

Provided by the Cobb County Department of Family and Children Services, Child Protective Services Intake Unit Mandated Reporter's Handbook- 1993-94.