North Dakota mandated reporters, including physicians, nurses, pharmacists and hospital staff, use SFN 1607 for a written report of suspected abuse, neglect or exploitation of a vulnerable adult, meaning an adult with a substantial mental or functional impairment. The two-page fillable form (10-2022) goes to Vulnerable Adult Protective Services under NDCC 50-25.2, and reports are due as soon as possible.
The reporter completes the whole form: reporter, alleged victim, suspected perpetrator if known, legal representative, collateral contacts and the reason for referral. There is no section for the adult or family.
Download the current version from the source each time; forms change without notice.
Report of Vulnerable Adult Abuse, Neglect, or Exploitation
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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An adult with a substantial mental or functional impairment. Functional impairment means being substantially unable, because of physical limitations, to live independently or provide self-care. Mental impairment means a disorder of thought, mood, perception, orientation or memory that grossly impairs judgment, behavior or the ability to live independently.
The central intake line is answered weekdays from 8 a.m. to 5 p.m. Central Time. After hours, leave a message with your contact information, submit SFN 1607, or use the online reporting system. For immediate danger, call law enforcement instead of APS.