Get the free Adult Protection Services Referral Form

This form is used to report concerns related to abuse, neglect, or exploitation of adults. It gathers reporter and victim information, details about the alleged perpetrator, and the type of allegations

How to fill out adult protection services referral

How to fill out adult protection services referral

1. Identify the concerns: Assess if there is reasonable suspicion of abuse, neglect, or exploitation of an adult.
2. Gather information: Collect relevant details such as the adult's name, age, address, and any specific incidents or observations.
3. Complete the referral form: Use the appropriate adult protection services referral form, providing clear and concise information.
4. Include details about the suspected perpetrator: If known, include information about the abuser or anyone involved.
5. Provide contact information: Include your name and contact details for follow-up questions or clarification.
6. Submit the referral: Send the completed referral form to the designated adult protection services agency, either by mail, fax, or electronically.
7. Follow up: If necessary, check back with the agency to confirm receipt and inquire about the status of your referral.

Who needs adult protection services referral?

1. Individuals who are elderly or disabled and may be at risk of harm due to abuse, neglect, or exploitation.
2. Adults who are unable to protect themselves due to physical or mental incapacity.
3. Caregivers, family members, or friends who suspect that an adult is suffering from abuse or neglect.

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What is adult protection services referral?

An adult protection services referral is a notification to authorities that an adult may be experiencing abuse, neglect, or exploitation, prompting an investigation and potential intervention.

Who is required to file adult protection services referral?

Professionals who work with vulnerable adults, such as social workers, healthcare providers, and law enforcement, are generally required to file a referral if they suspect abuse or neglect.

How to fill out adult protection services referral?

To fill out an adult protection services referral, you typically need to provide details about the individual involved, the nature of the suspected abuse or neglect, any supporting evidence, and your contact information.

What is the purpose of adult protection services referral?

The purpose of an adult protection services referral is to ensure the safety and well-being of at-risk adults by facilitating intervention and support from designated authorities.

What information must be reported on adult protection services referral?

Important information to report includes the adult's name and address, details of the suspected abuse or neglect, the names of any involved parties, your observations, and your contact information.