Mandated Reporter Form

The Elder Abuse Mandated Reporter Form

The Elder Abuse Mandated Reporter Form is a form developed and maintained by the Executive Office of Elder Affairs. It is required only for Mandated Reporters, and should to be submitted to Springwell within 48 hours of a verbal report of abuse. The Mandated Reporter Form does not take the place of a verbal report. Springwell is not able to respond to a report until a verbal report is received. To make a report the reporter must call the state-wide Elder Abuse Hotline at 1-800-922-2275.

Download a copy of the form here.

The form should be mailed to:

Springwell, Attn: PS
307 Waverley Oaks Road, Suite 205
Waltham MA 02452
or faxed to 617-926-9783.

307 Waverley Oaks Road, Suite 205, Waltham, MA 02452
Phone
617-926-4100
Fax
617-926-9897
TTY
617-923-1562
General email
inforef@springwell.com
Volunteer Program Email
volunteer@springwell.com