Get the free APS INTAKE FORM

APS INTAKE FORM SECTION A: CASE CONTROL INFORMATION CLIENT # DATE OF INTAKE TIME AGENCY NAME TYPE ? 800U ? AGENCY ? AM ? PM SECTION B: ALLEGED VICTIM (AV) INFORMATION DOB: ALLEGED VICTIM S NAME AGE:

How to fill out aps intake form

How to Fill Out APS Intake Form:

1. Start by obtaining the APS intake form. This form can usually be found on the website of the relevant Adult Protective Services (APS) agency in your state or country.
2. Read the instructions carefully to ensure that you understand the purpose and requirements of the form. It is essential to provide accurate and complete information.
3. Begin by providing your personal information, such as your name, address, phone number, and email address if applicable.
4. Fill out the section related to the individual for whom the APS intervention is being sought. This includes their name, address, age, and any additional relevant details.
5. Indicate the reason for the APS involvement and provide a detailed description of the situation that necessitates intervention. Be specific and include any supporting documentation or evidence, if available.
6. Answer any questions related to the alleged abuse, neglect, or exploitation, if applicable. This may include providing additional details about the alleged perpetrator, witnesses, or specific incidents.
7. If you have any concerns or additional information that you think is important for APS to know, include it in the appropriate section or attach it as a separate document.
8. In some cases, you may be required to sign and date the form to certify the information provided is true and accurate.
9. Review the completed form to ensure it is legible, organized, and free of any errors or omissions.
10. Submit the form to the designated APS office according to their instructions, which may include mailing, faxing, or personally delivering it.

Who Needs APS Intake Form?

1. Individuals who suspect or have witnessed abuse, neglect, or exploitation of an older adult or person with a disability may need an APS intake form.
2. Family members or friends who are concerned about the well-being and safety of an elderly or disabled person may also need to fill out an APS intake form.
3. Professionals working in healthcare, social services, law enforcement, or any other field who come across cases that require APS intervention may be required to complete an APS intake form.

Note: The specific requirements, procedures, and eligibility criteria may vary depending on the jurisdiction and the APS agency involved. It is always recommended to consult the official APS website or contact their office directly for the most accurate and up-to-date information.

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