Connecticut mandated reporters, including physicians, nurses and physician assistants, must make an oral report to the DCF Careline or law enforcement within 12 hours of suspecting abuse or neglect. Within 48 hours of that oral report, they submit DCF-136. The 2-page form records the child, caregivers, suspected perpetrator, the injury or neglect and how it became known, prior history, and action taken to help the child.
The mandated reporter completes the whole form, including the reporter section, signature and position.
Download the current version from the source each time; forms change without notice.
Report of Suspected Child Abuse or Neglect
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The written report is due within 48 hours of the oral report. The oral report itself must be made to the DCF Careline or law enforcement as soon as practicable, and no later than 12 hours after the reporter has reasonable cause to suspect abuse or neglect.
Send it to the DCF Area Office for the child's area; the form lists each office with its address and fax line. Non-emergency reports can be filed online through the DCF Mandated Reporter Portal instead of the paper form.