Report Adult Abuse

1. Your Details


*If you choose to stay Anonymous and we are unable to locate the Adult in question or contact you for validation, the case may not be able to be investigated.
If you would like to receive a digital record of this submission, ensure that your email is provided in “Reporter Information” on the next page.

2. Your Information (Reporter)

Please provide your contact information. 

If the intake is assigned to an investigator, the investigator will contact you to obtain more information and keep you updated if required.

Per 43A O.S. § 10-105.1, the identity of the person who reports the incident of abuse is confidential.

*Indicates required fields. 
















3. Incident Information


*If date is unknown, please use today's date.

*Time cannot be in the future.












4. Alleged Victim(s) Involved in the Incident

Alleged Victim Information












If you are making a report for a child under 18, please contact the Abuse and Neglect Hotline at 1-800-522-3511.

If you are making a report for a child under 18, please contact the Abuse and Neglect Hotline at 1-800-522-3511.







"Vulnerable Adult" means an adult who, because of physical or mental disability or other impairment, may be subject to maltreatment and is substantially impaired in his or her ability to independently:

(A) provide adequately for his or her own care or custody;

(B) manage his or her property and financial affairs effectively;

(C) meet essential requirements for mental or physical health or safety; or

(D) protect himself or herself from maltreatment without assistance. 


This determination is not made based on a person's eligibility for disability benefits from any source or on the impairment being permanent, but solely on the adult's reported physical or mental condition at the time an APS referral is received.





*If there are multiple Alleged Victims who reside in different residences, please complete a separate Abuse, Neglect, and Exploitation form submission for each residence.

5. Alleged Abuser(s) Involved in the Incident



Alleged Abuser Information













If you are making a report for a child under 18, please contact the Abuse and Neglect Hotline at 1-800-522-3511.











6. Witness(es) Involved in the Incident


Witness Information












If you are making a report for a child under 18, please contact the Abuse and Neglect Hotline at 1-800-522-3511.