Child Abuse Central Index Forms
The following forms are for use by government agencies and mandated reporters pertaining to child abuse cases. If you suspect a case of child abuse in your neighborhood, you should contact your county child welfare agency or local law enforcement agency.
Child Abuse or Severe Neglect Indexing Form
This form is for use by government agencies mandated to submit child abuse case information pursuant to Penal Code (PC) section 11169.
- Form BCIA 8583, pdf
- Instructions, pdf
CACI Inquiry Forms
The following forms must be completed for inquiries of CACI information.
Authorized Agencies Only
Facsimile Inquiry for Child Abuse Central Index (CACI) Search
This form is for use by Law Enforcement and authorized agencies seeking information in the CACI.
Public
Child Abuse Central Index Self Inquiry Request
This form is for use by private citizens. Pursuant to PC section 11170(f), "Any person may determine if he or she is listed in the CACI by making a request in writing to the Department of Justice."
- Form BCIA 4056, pdf
- Form BCIA 4056 (Spanish), pdf
If you have questions regarding the use of the forms, contact the CACI at: CACI-Inquiry@doj.ca.gov
Links to topics below
These forms are for use by government agencies and certain individuals to report information required by law in child abuse cases. If you suspect a case of child abuse in your neighborhood, you should contact your county child welfare agency or your local police department or sheriff's office.
Department of Justice (DOJ) Forms
If you have questions regarding the use of the forms, contact the Child Abuse Central Index (CACI) at: CACI-Inquiry@doj.ca.gov.
Child Abuse Central Index Inquiry Request for Out-of-State Foster & Adoption Agencies
Instructions and Form for use by Out-of-State Foster & Adoption Agencies.
- Form BCIA 4057, pdf
- Instructions, pdf
- Form BCIA 4056, pdf
- Form BCIA 4056 (Spanish), pdf
- Form BCIA 8583,.pdf
- Instructions, pdf
The Governor's Office of Emergency Services (Cal OES) Forms
The forms below pertain to child abuse. For questions about the forms, contact Cal OES.
Medical Report: Suspected Child Physical Abuse and Neglect Examination.
Used by physicians for reporting evidence of child sexual abuse. Form should be used in lieu of DOJ Form 900 for cases of chronic sexual abuse of minors.
- Cal OES 2-900, pdf
- California Medical Protocol for Examination of Child Physical and Neglect Victims, pdf
