Report Child or Adult Abuse Use this form to report a situation that you feel should be brought to our attention. CALL 911 for an emergency situation. Your Name (The agency will not give your name to the person suspected of abusing the child.) Your Phone Number Your Email DETAILS: Short Summary Of Issue (required) Name of Offender(s) You Are Reporting (required) Is Parent The Offender? YesNo Name of Victim(s) You Are Reporting (required) Address You Are Reporting (required) Details About Issue You Are Reporting Answer this question in order to submit your report 2+2?