Diocese Of Tyler Catholic Schools Office Cps (Child Protective Services) Report printable pdf download

Diocese Of Tyler Catholic Schools Office Cps (Child Protective Services) Report

DIOCESE OF TYLER

CATHOLIC SCHOOLS OFFICE

CPS (CHILD PROTECTIVE SERVICES) REPORT

I, _____________________________, made a report to CPS on ____________________________

DATE

at ____________________________.

TIME

The CPS person who took my call was _______________________________________________.

PRINT NAME

The Case Number given was __________________________________.

(_______ My report was made through your secure website. A copy of the response I received is

attached.)

The report concerned ___________________________________________

PRINT NAME OF CHILD

The circumstances that demanded the report (date and place of the alleged incident and any other

information)

________________________________________________________________________________

Signed: ____________________________________________________________

EMPLOYEE MAKING THE REPORT

Signed: ____________________________________________________________

PRINCIPAL OF THE SCHOOL

Directions:

The principal will mail this form to CPS confirming the report.

If the report was made through the DPS secure website, attach all documentation received.

The principal will keep a copy of this form, along with documentation at the school.

The principal will send a copy of this form, along with documentation to the Superintendent.

Know that the Superintendent will copy the report and send a copy to the Promoter of Justice for the Diocese of

Tyler.

The report will be mailed within three (3) working days of the phone call or website report.

Diocese Of Tyler Catholic Schools Office Cps (Child Protective Services) Report