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DCF Referral Form and Instructions

 DCF Mandated Reporting

DCF Referral form and instructions



The form is meant to be used in Adobe Reader. In order to properly open the form, you must first download it to your local computer and then launch it with Adobe Reader so it can be opened and completed. You cannot open it directly from this webpage. You cannot use a Chromebook, phone or iPad to use this form - it must be done from a Mac or PC.

1. To download the file, right-click on the link below and save the file to your downloads folder (using the menu option to either "save as" or "save link as" or "save target as").

RIGHT CLICK HERE to save the Referral form to your downloads.

2. Click the folder icon on the bottom left on your PC and locate your downloads folder, then double-click the file that you just saved (should be named DCF Referral Form.pdf with today's date) and it will open with Adobe Reader. If Adobe Reader is not your default application for opening PDF files, you may need to right click on the file, choose "open with" and select Adobe Reader as the program to launch the file.

folder icon on pcIf you get the text shown below when opening the document, you did not save and open it correctly.

error message

3. When the file is opened correctly, you will see the instructions below. You will need to check the box that says "I have read and understood my responsibility to the above" and then the interactive form will open and you can populate it.


pdf form screenshot

4. Once you have completed the form, save and rename the form to your local computer using the "Save As" menu option. Name the file so you do not overwrite the form template and save to the desired location on your computer.

5. Follow the instructions on the "DCF Mandated Reporting" page of this website (link at right) and send the completed form to


Effective December 5, 2018, the Department of Children and Families (DCF) is introducing electronic reporting that will be available to mandated reporters from school systems for non-emergent child abuse and neglect concerns. The basis for this process is Public Act 18-67, which allows DCF to establish a pilot program to permit certain mandated reporters of child abuse and neglect to submit their reports electronically and, starting October 1, 2019, allows all such reporters, as well as other individuals, to submit reports of suspected child abuse or neglect in this manner. A mandated reporter who makes an electronic report pursuant to this section shall respond to further inquiries from the Commissioner or the Commissioner's designee made within twenty-four hours of such report. Based on specific criteria, certain reports by a specific cohort of mandated reporters will serve as the Pilot Program.

DCF is committed to ensuring that there is a timely and responsive system to accept all calls concerning the safety and well-being of children. We recognize that the last few months have presented multiple challenges, largely due to the significant increase in the volume of calls and limitations to the phone system. To remedy these issues with recognition that call volume will remain high, the Department has been approaching improvements in a multi-pronged way, inclusive of staffing, needed enhancements to the phone system and maximizing advanced technology. While this effort serves as a pilot, we are confident it will improve the timeliness of reports and response time. We will be evaluating the effectiveness of this pilot to inform future development that will continue to roll out over the course of 2019 and look forward to your feedback.