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STATE OF KANSAS Department for Children and Families Prevention and Protection ServicesADULT ABUSE, NEGLECT, EXPLOITATION CENTRAL REGISTRY RELEASE OF INFORMATION, PPS 10400 REV 1/18, give permission
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Gather all necessary information about the alleged abuse, neglect, or exploitation.
02
Start by filling out the basic details about the victim, such as name, age, and contact information.
03
Provide a detailed description of the incident, including date, time, location, and any witnesses present.
04
Specify the type of abuse, neglect, or exploitation that occurred, such as physical abuse, emotional neglect, or financial exploitation.
05
Include any supporting documentation or evidence, such as photographs, medical records, or financial statements.
06
Provide your own contact information in case further clarification is needed.
07
Submit the completed form to the appropriate authorities or agency responsible for handling abuse, neglect, or exploitation cases.
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Keep a copy of the filled-out form for your records.

Who needs abuse neglect or exploitation?

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Anyone who suspects or has witnessed abuse, neglect, or exploitation can report it. This includes concerned individuals, family members, friends, neighbors, healthcare professionals, educators, social workers, law enforcement officials, and other mandated reporters.
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Abuse, neglect, or exploitation refers to harmful behaviors directed towards individuals, often vulnerable populations, which can include physical, emotional, or financial abuse, neglect of basic needs, or manipulation for personal gain.
Mandated reporters, such as healthcare professionals, teachers, social workers, and law enforcement officials, are required to report instances of abuse, neglect, or exploitation.
To fill out a report on abuse, neglect, or exploitation, provide detailed information about the incident, including the names of those involved, dates and locations, descriptions of the behavior observed, and any supporting documentation or evidence.
The purpose of reporting abuse, neglect, or exploitation is to protect vulnerable individuals, ensure their safety, and provide necessary interventions to prevent further harm.
Reports must include the names and addresses of the victim and alleged perpetrator, a description of the incident, the relationship between the parties, and any immediate safety concerns.
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