Missouri Ozarks Community Action, Inc Head Start Child Abuse/Neglect Report You are a mandated reporter of child abuse/neglect. Hotline: 1-800-392-3738 If you suspect that a child has been abused or neglected; you are required by law and Head Start Regulations to report that suspicion. You are reporting an incident of suspected child abuse/neglect Has this incident been reported to Family Services? Did you identify yourself as a Head Start Employee? Yes No Yes No Has a report been made to the parents? Did the incident reported involve another Head Start Child? Yes No Yes No Did the incident involve a Head Start staff member or volunteer? Did the incident occur at the Head Start center? Yes No Yes No Child's name: Date of Report Time of Report: Reported By: Type of abuse/neglect Select Physical Neglect Medical Neglect Physical Abuse Sexual Abuse Emotional Abuse Other Details of incident: Your name: Your e-mail address: Your Center: Select Belle Camdenton Crawford Co Dixon Eldon Iberia Lebanon Linn Creek Osage Rolla Gasconade Co St James Waynesville Tri-County The form you are about to submit will be sent directly to the Program Director. You must still follow-up with a written report (Child Abuse - Neglect Reporting Instructions). This serves as your immediate notification of the Director. You will receive a receipt by return email. Head Start Main Page