Date:

Re:

Dear :

This acknowledges your report of possible child abuse and neglect, received by this office on . Thank you for your concern and for your compliance with Section 19-7-5 of the Official Code of Georgia, Annotated. We will not reveal your name to the subject of this report, however, if court action is necessary to protect the child, you may be subpoenaed to appear at the hearing. A reporter is protected from civil or criminal liability for any report made in good faith.

As a mandated reporter, you may receive the following information concerning this case at your request: whether the case investigation is on-going or completed, and if completed, whether the abuse/neglect was substantiated or unsubstantiated.

Your report was processed with the following response decision assigned. If you have any questions concerning your report or the response decision, please contact the County Department of Family and Children Services.

Sincerely,

Social Services Case Manager

( FORMCHECKBOX ) Assigned for Investigation

( FORMCHECKBOX ) 24 Hour

( FORMCHECKBOX ) 5 Day

( FORMCHECKBOX ) Not assigned for investigation

( FORMCHECKBOX ) Screened out and Referred to another agency

( FORMCHECKBOX ) Screened out

cc: DFCS

(Name of County)

CPS_18 Mandated Reporter Letter (Rev. 09/06) Page 1 of 1