*HEAD START/EHS/PRESCHOOL ONLY** UMHS Suspected Child Abuse Report Form

*HEAD START/EHS/PRESCHOOL ONLY** UMHS Suspected Child Abuse Report Form

Upload a completed and eligible CANS Report. Send hard copy to Health & Mental Health Manager through agency mail.

Upload completed CANS Form:

Attach Files
Location of Disclosure:
Date of Disclosure: Date of Disclosure: / MM / DD YYYY
UMHS Staff Making Report: UMHS Staff Making Report: First Last