Division of Licensing & Protection Abuse Reporting Form
The Division of Licensing & Protection has a new reporting form that can be utilized by anyone wishing to file a report, including facility mandated self reports. The form is completed from a secure environment so all information that you provide will be protected. Once you have completed the form you will receive a confirmation of your submission, including the Report ID assigned to your report. Also, you will be able to provide us with an e-mail address so that you can get an e-mail confirmation of your submission that you can keep for your records. You will have one chance to print the report for your records before final submission.
This new report has been designed to be user friendly. We ask that you give the most complete information that you are able to provide. For example, if you are not able to provide the exact age of the Alleged Victim or Alleged Perpetrator, please give us your best estimate. This is also true for addresses of parties involved. Although we know sometimes you do not have all the required information, especially in the case of the Alleged Perpetrator, again do your best. If you know a first name but not a last then you can enter this by using “unknown” in that particular field.
You will not be able to submit the report with out providing information on the Alleged Victim. You do this by going to the section marked Alleged Victim and clicking “Add” this will open up the form for you to be able to provide as much information as you can. The more information that you are able to provide the better able our staff will be to assess the needs of the Vulnerable Adult and make the appropriate referrals or assign for further investigation. You do not have to prove that a vulnerable adult has been abused, exploited or neglected in order to make a report; you only need to have reason to believe that abuse may have occurred.
Please provide as much information as you can. (Required fields are marked.) You can choose to check that you want to be anonymous, however, your name and contact information will still be required in order for us to contact and obtain more information if necessary. If we do not receive all pertinent information needed it could result in the report being closed as an “Incomplete Report”.
You may also contact us directly if you suspect that a vulnerable adult has been harmed, or if you are having problems using the online report. In Vermont call toll-free 1-800-564-1612 or out-of-state call (802) 871-3326.
THIS LINK WILL TAKE YOU AWAY FROM THE DIVISION OF LICENSING AND PROTECTION'S WEBSITE TO A SECURE SITE TO ENABLE YOU TO FILE YOUR REPORT.
PLEASE TURN OFF YOUR POP UP BLOCKER BEFORE GOING TO THE SITE BELOW - OTHERWISE ALL FIELDS WILL NOT APPEAR.