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Adult protective services wv 2026

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The document is a mandatory reporting form developed by the West Virginia Department of Health and Human Resources for reporting suspected abuse, neglect, financial exploitation, or immediate risks to adults. It outlines the necessary information about the alleged victim and perpetrator, details of the incident, and required actions for mandatory reporters. The form must be completed by designated individuals and submitted to appropriate authorities within 48 hours of an incident.

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Click ‘Get Form’ to open the Adult Protective Services Mandatory Reporting Form in the editor.
Begin by filling out the 'Alleged Victim Information' section. Provide the name, age, address, and phone number of the victim. Ensure you include their current location and any relevant facility details.
Next, complete the 'Alleged Perpetrator Information' section. Include their name, age, address, relationship to the victim, and contact information.
In the 'Allegations' section, detail the incident by providing dates, times, locations, and descriptions of what occurred. Be thorough in explaining any actions taken to prevent further abuse.
Finally, fill out your own information in the 'Reporter Information' section. Remember that this information is confidential and should be handled accordingly.

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