Report a Case

Complete the form below. If there is immediate danger, call SAPS (10111) or emergency services first.

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Your Details (Reporter)

First name *

Last name *

Email *

Phone *

Provide numbers where we can reach you 08:00–17:00.

Date of birth

Address

Your relationship to the child *

How did you hear about us?

Previously contacted our organisation?

Have you had a psychological evaluation?

Do you have legal representation?

Your custody status

Has anyone in your household been accused of child abuse?

Any prior history with child protection services?

Alleged Perpetrator (statistical info)

First name

Last name

Relationship to child(ren)

Phone

Age

Sex

Ethnicity

Custody/visitation status

DOB

Does the alleged perpetrator have legal representation?

Has the alleged perpetrator had a psychological evaluation?

Previously faced charges of criminal violence?

Previously accused of child abuse?

If “Yes” to any, please upload supporting documentation at the end of this form. :contentReference[oaicite:2]{index=2}

Court / Case Information

Does the child have an ad litem?

Is there a pending civil case?

Civil Court #

Civil Case #

Court County

Court Province/State

Did you or someone else contact law enforcement?

Did law enforcement file charges?

Did the Prosecutor/DA accept the charges?

Is there a pending criminal case?

Criminal Court #

Criminal Case #

Court County

Court Province/State

Did child protection services (DSD/CPS) get contacted?

Did CPS validate the abuse allegations?

Child 1

First name *

Last name *

Date of birth

Sex

Ethnicity

Address

Municipality/District

Documentation supports what type(s) of abuse

Physical Mental Emotional Sexual Other

Are there more kids in the home?

Are they also abused?

Exam by doctor with expertise in child abuse?

Exam by any other doctor?

Medical evidence supports abuse?

Has the child had a psychological evaluation?

Is the child attending ongoing therapy?

Disclosed abuse to therapist?

Interviewed by social worker?

Disclosed abuse to social worker?

If “Yes” to any medical/therapy questions, upload records below (exam, diagnosis, etc.). :contentReference[oaicite:3]{index=3}

Child 2 (optional)

First name

Last name

Date of birth

Sex

Ethnicity

Tell us a little about what's going on *

Upload Supporting Files

Upload police reports, medical/therapy reports, affidavits, photos, case numbers, etc. (multiple files allowed)

I consent to Childwatch SA reviewing this information and, where necessary to protect the child, sharing it with appropriate authorities or professionals. *

Priority

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Having trouble with the form or need to attach large files? Email us instead: reports@childwatchsa.org