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OMB No. 11210329
Approval Expires 12/31/2023
U.S. Department of Justice
Office of Justice Programs
National Institute of Justice FY24 Research on the Abuse, Neglect, and
Financial Exploitation of
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How to fill out adult protective services functions

How to fill out adult protective services functions
01
Gather all necessary information about the person for whom you are filling out the adult protective services functions form.
02
Start by filling out personal information, including the individual's name, date of birth, and contact information.
03
Provide details about the person's living situation, such as their current address and any other relevant contact information.
04
Document information about the person's medical history, including any existing health conditions, allergies, or medications they are taking.
05
Include information about their financial situations, such as income sources, assets, and debts.
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Describe any observed signs of abuse, neglect, or exploitation, and provide supporting evidence or documentation if available.
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Make sure to be thorough and accurate in documenting any additional relevant information about the person's mental capacity, capacity to make decisions, and any other relevant factors.
08
Review the completed form for accuracy and completeness before submitting it to the appropriate adult protective services agency.
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If required, provide any supporting documentation or evidence along with the form.
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Keep a copy of the filled-out form and any supporting documents for your records.
Who needs adult protective services functions?
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Adult protective services functions are typically needed for vulnerable adults who may be at risk of abuse, neglect, or exploitation.
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Individuals who are elderly, disabled, or have cognitive impairments are often the primary recipients of adult protective services.
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Anyone who suspects or witnesses signs of abuse, neglect, self-neglect, or financial exploitation in an adult may also seek adult protective services functions.
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Family members, caregivers, healthcare professionals, social workers, and legal guardians often play a crucial role in identifying the need for adult protective services and initiating the process.
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What is adult protective services functions?
Adult protective services (APS) functions involve the investigation of reports of abuse, neglect, or exploitation of vulnerable adults, providing services to help them remain safe and independent, and ensuring their rights are protected.
Who is required to file adult protective services functions?
Individuals who suspect that a vulnerable adult is being abused, neglected, or exploited are required to file a report with adult protective services. This includes mandatory reporters like healthcare professionals, social workers, and law enforcement.
How to fill out adult protective services functions?
To report to adult protective services, one typically needs to fill out a report form that includes details about the adult in question, the nature of the concerns, any evidence or observations, and personal information about the reporter if applicable.
What is the purpose of adult protective services functions?
The purpose of adult protective services functions is to protect vulnerable adults from harm, ensure their well-being, provide necessary support services, and promote their ability to live independently.
What information must be reported on adult protective services functions?
Reports to adult protective services must include the adult's name, age, address, details of the suspected abuse or neglect, the reporter's information (if required), and any relevant evidence or witness statements.
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