Report Abuse

If you suspect abuse or neglect, call 855-444-3911 any time day or night. This toll-free phone number allows you to report abuse or neglect of any child or adult to the Michigan Department of Human Services.

 

If you are a Child Protective Service worker or a member of Law Enforcement, please fill out the form below and someone will respond to you within 24 hours.  If it is an emergency, please call our office to schedule at 989-723-5877.

 

Request for Forensic Interview
* Required
Child's Information
First Name: *
Your answer
Last Name: *
Your answer
Address:
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City:
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Zip
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Date of Birth *
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DD
/
YYYY
Alleged Perpetrator's Information
First Name: *
Your answer
Last Name: *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Relation to Child *
Your answer
Non-offending Caregiver's Information
First Name:
Your answer
Last Name:
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Contact Number
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Relation to Child
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Referral Information
Referral Name: *
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Referring Agency *
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DIRECT Phone Line Where You Can Be Contacted: *
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Referral Email:
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Time frame/availability for interview: *
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Brief description of allegations: *
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This form was created inside of Child Abuse Prevention Council of Shiawassee Co. Report Abuse