Call Type - Electronic Mandated Reporter

Suspected Child Abuse Report (SS 8572)

To be completed by Mandated Child Abuse Reporters - Pursuant to Penal Code Section 11166.

Please complete all known fields and submit, even if some of the information is not known. All fields are required unless noted otherwise.

Call Type

A CBAS number is a 7-digit, temporary reference number (i.e.: 0101-000) A consultation number is a 15-digit call reference number (i.e.: A20210000-000000)

Call Type

Year of Report

Consultation Number (ARES)

CBAS Number

Referral Number

Reporter’s telephone number provided to Hotline

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Los Angeles County Department of Children and Family Services

Suspected Child Abuse Report (SS 8572)

Los Angeles County
Department of Children
and Family Services