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Child Abuse History Record Request for Private Adoption NOTE: This form must be submitted by the agency identified at the bottom of this page. The applicant may NOT SUBMIT THIS FORM DIRECTLY to the
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01
Gather all the necessary information and documents related to the child.
02
Ensure privacy and confidentiality of the child's information.
03
Fill out the child abuse history record form accurately and truthfully.
04
Provide detailed information about any past incidents of child abuse or neglect.
05
Include dates, names, locations, and descriptions of the abuse or neglect.
06
Submit the completed form to the appropriate authority or organization.

Who needs child abuse history record?

01
Social workers
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Child protective services agencies
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Law enforcement agencies
04
Medical professionals
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Child advocacy centers
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Child abuse history record is a documentation of any reported incidents of child abuse or neglect involving an individual.
Individuals who work or volunteer in positions that involve contact with children are required to file a child abuse history record.
Child abuse history record can be filled out by providing details of any reported incidents of child abuse or neglect, as well as personal information and background checks.
The purpose of child abuse history record is to ensure the safety and well-being of children by screening individuals who have contact with them.
Information such as reported incidents of child abuse or neglect, personal information, and background checks must be reported on child abuse history record.
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