Essay about Abuse Report Form

Submitted By TinaDowns
Words: 603
Pages: 3


Provide Social Services

Identify, record, and report suspected
Abuse of individuals

Abuse Report Form

Date: 02 December 2002 Time: 11:15am

Notifier: Gloria Allen (neighbour) Address: 22 York Street, Whanganui Phone: 06 345 2222

Client/s: Suzie Wong DOB: 12th December1987

Address: 66 Bell Street


Family Details: Suzie living with her parent has 6 siblings. Fathers brother Uncle Sam is boarding with them, aged 45years. Have parties at parents place nearly every week-end.

MOC: Sandy Wong Address: 66 Bell Street Whanganui

Phone: 06-344382 Occupation: Home Executive

FOC: Bonjoo Wong Address: 66 Bell Street Whanganui

Phone: 06-344382 Occupation: Shearer


1. Suzie disclosed to Gloria on the 1st December 2002 that she had been raped by her uncle Sam about 1 month ago.
2. It has been happening every week-end after the parties, while everyone is asleep.
3. Suzie is afraid to tell her parents as her Uncle Sam has threatened to kill her if she does.
4. Suzie was a virgin when it happened, she has missed her period and afraid she maybe pregnant.
5. Suzie is terrified that uncle Sam may also hurt her other siblings as her sisters are only 12 years and 14 years old.
Incident: (Witnesses, Whereabouts)

1. There are no Witnesses and Suzie has not told anyone else.


For the safety of Suzie and the other children this case is urgent and needs to be investigated.

1. Suzie and other children uplifted from the house

What have you done?

Report to Tupoho Maatua Whangai

Whanau Involvement

▪ Mother sometimes works at the sheds with husband ▪ Uncle Sam is left at home baby-sitting the kids. ▪ Suzie is the eldest, 2 sisters aged 12 & 14 years, and four brothers aged from 6, 7, 9, & 10 years ▪ Mother and fathers whanau both from Whanganui.

Community Involvement

• Involved in Rugby League Club • And Golf Club

Notifier will be home Thursday 7th December 2002 at 3pm


1. Contact notifier at home for confirmation of Suzie’s parents address

2. Arrange hui with parents at Tupoho Maatua Whangai Trust, 29 Ridgeway Street, Whanganui or at Parents residence. Hui 4th December 2002

3. Speak with the child

4. Contact Doctor – medical check & any required medical information

5. Contact School – Principal and School Teacher – Obtain a report of child

6. Contact list of people Parents will give to attest to Parents character


1. If need be refer case to Child Youth Family Services

Types of Abuse

Physical: Bruising, Hitting,