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Maryland DHS/SSA 180: Child Abuse Report Form

Maryland health practitioners who have reason to believe a child has been abused or neglected must report orally right away, then file this written report within 48 hours of the contact, examination or treatment that raised the concern. The 180 goes to the local department of social services, or the police, in the jurisdiction where the incident allegedly occurred, with a copy to the State's Attorney.

Who completes it

The mandated reporter completes all items, and the reporter named should be the person who witnessed or has first-hand knowledge of the incident. The last items record the date of the oral report and the local department staff member who took it; the family completes nothing.

Submitting and payment

How to submit it
Fill it in by hand or electronically (save the PDF first), then print and fax it to the local child protective services office within 48 hours of the oral report, and give a copy to the local State's Attorney's office.
Who pays
There is no fee; filing is a legal duty, and good-faith reporters are immune from civil liability and criminal penalty.

Good to know

  • Identify only one child per report, and respond to every item even if the answer is unknown or none.
  • Even if the oral report is screened out as not meeting CPS criteria, you must still submit the written 180 and keep a copy for your records.
  • Hospital staff must notify the head of the institution or a designee, but that does not replace calling the local department, filing the 180 and notifying the State's Attorney.
  • Since October 1, 2016, a local department that believes a mandated reporter knowingly failed to report must file a complaint with the reporter's licensing board or employer.

Get the official form

Download the current version from the source each time; forms change without notice.

Report of Suspected Child Abuse/Neglect

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

When is the Maryland 180 form due?

Within 48 hours after the contact, examination, attention or treatment that led you to believe the child was abused or neglected. The oral report comes first and must be made immediately to the local department of social services or the police in the jurisdiction where the incident allegedly occurred.

Will the family learn who reported?

Without your written permission, the local department will not share the reporter's identity unless a court orders it. Item 29 lets you waive confidentiality if you choose. You may still be contacted during the investigation and may be called to take part in an administrative hearing.

Is there a separate Maryland form for substance-exposed newborns?

Yes. Maryland DHS uses the DHS/SSA 2079 Substance-Exposed Newborn Reporting Form, which is filled out, printed and faxed to the local department of social services. It is listed on the same DHS mandated reporter page as the 180.