MI DHS-3200 2012 free printable template

Address No. Street 15c. City 16d. State 16e. Zip Code 16f. Phone No. 45 Private Agency Social Worker 46 Court Social Worker 47 Other Social Worker 48 FIS/ES Worker/Supervisor 49 Social Services Specialist/Manager CPS FC etc. 52 DHS Facility Personnel 55 Private Social Agency Personnel 56 Court Personnel DHS-3200 Rev. 2-12 Previous edition may be used. MS Word TO BE COMPLETED BY MEDICAL PERSONNEL WHEN PHYSICAL EXAMINATION HAS BEEN DONE 20. REPORT OF ACTUAL OR SUSPECTED CHILD ABUSE OR NEGLECT...

How to fill out 3200 form

How to fill out MI DHS-3200

1. Obtain the MI DHS-3200 form from the Michigan Department of Health and Human Services website or your local office.
2. Ensure you have all necessary documents and information on hand, such as personal identification, address, and any relevant financial details.
3. Fill in your personal information, including your name, address, and contact details in the designated areas.
4. Provide information about your household members and their relationship to you.
5. Report your income and any other financial resources accurately, following the instructions on the form.
6. Review the completed form for accuracy and completeness.
7. Sign and date the form at the bottom before submission.
8. Submit the completed MI DHS-3200 form to your local Michigan Department of Health and Human Services office, either in person or via the provided mailing options.

Who needs MI DHS-3200?

1. Individuals or families in Michigan applying for public assistance programs, such as food assistance, cash assistance, or medical assistance.
2. Those who need to report changes in their household or income status.
3. Current recipients of assistance who are required to complete the form to maintain eligibility.

Instructions and Help about 3200 form

People Also Ask about

How do I file a CPS report in Michigan?

Anyone, including a child, who suspects child abuse or neglect, can make a report by calling 855-444-3911. In addition, the Child Protection Law requires certain professionals to report suspected child abuse or neglect. Review the Mandated Reporters section of our website for more details.

Can you file a CPS report online in Michigan?

A Guide to Online Reporting This Guide to Online Reporting is designed to help mandated reporters use the Michigan Online Reporting System (MORS) to submit complaints of suspected child abuse or neglect to Michigan Department of Health and Human Services (MDHHS).

What is the mandated reporting policy in Michigan?

Michigan Child Protection Law requires certain professionals to report their suspicions of child abuse or neglect to Centralized Intake (CI) at the Department of Health and Human Services (DHHS). These people are mandated reporters and have established relationships with children based on their profession.

Can you make a CPS report online in Michigan?

A Guide to Online Reporting This Guide to Online Reporting is designed to help mandated reporters use the Michigan Online Reporting System (MORS) to submit complaints of suspected child abuse or neglect to Michigan Department of Health and Human Services (MDHHS).

What is a CPS 3200?

DHS-3200, Report of Actual or Suspected Child Abuse or Neglect.

Can CPS tell you who reported you in Michigan?

Both parents have the right to see everything in a CPS file except the name of the person who made the complaint about abuse and neglect. You must ask for the records in writing at your local MDHHS office.

What is a 3200 form in Michigan?

Report of Actual or Suspected Child Abuse or Neglect - DHS-3200. Was Complaint Phoned to MDHHS? INSTRUCTIONS: REPORTING PERSON: Complete items 1-19 (20-28 should be completed by medical personnel, if applicable). Send to Centralized Intake at the address listed on page 2.

How do I contact local CPS?

Click on the website above for information on reporting or call Childhelp (800-422-4453) for assistance.

How to file a 3200 in Michigan?

Michigan Disproportionality Reporting online eliminates the requirement to fill out a DHS-3200 form. If you call the hotline to report, please fax or email the completed DHS-3200 form to Centralized Intake within 72 hours. Do not use the Michigan Online Reporting System if you already called the hotline.

What is the CPS number in Michigan?

In addition to making a report to law enforcement, anyone, including a child, who suspects child abuse or neglect, can make a report to Children's Protective Services by calling 855-444-3911.

What happens when you call CPS on someone in Michigan?

CPS has 30 days to complete an investigation unless extenuating circumstances require an extension. A CPS investigation must begin within 24 hours and usually includes: Face-to-face interviews with the alleged child victim(s), the child's caretaker(s), the alleged perpetrator(s). Viewing the family's home.

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What is MI DHS-3200?

MI DHS-3200 is a specific form issued by the Michigan Department of Health and Human Services that is used to report information regarding certain health-related services or programs.

Who is required to file MI DHS-3200?

Individuals and organizations that are involved in providing specific health services that fall under the jurisdiction of the Michigan Department of Health and Human Services are required to file MI DHS-3200.

How to fill out MI DHS-3200?

To fill out MI DHS-3200, the filer must provide relevant information as instructed in the form, including organization details, service information, and any required statistical data as specified by the Michigan Department of Health and Human Services.

What is the purpose of MI DHS-3200?

The purpose of MI DHS-3200 is to collect essential data that helps the Michigan Department of Health and Human Services in monitoring and evaluating public health services and programs.

What information must be reported on MI DHS-3200?

The information that must be reported on MI DHS-3200 includes details about the services provided, the demographics of individuals served, service outcomes, and any other relevant statistics as mandated by state regulations.