Child Maltreatment Protocol

The following forms are to be used in medical evaluations for physical abuse, neglect and/or non-acute sexual abuse (more than 72 hours from last incident) in an outpatient facility/ office setting when a law enforcement report has been filed.

For evaluations of acute sexual assault (less than 72 hours from the incident), please use the SLED Sexual Assault Evidence Collection Kit (Rape Kit), which can be ordered by contacting SLED directly at 803-737-9000.

Requires Adobe Acrobat Reader. Get Acrobat Reader here.

Child Maltreatment Protocol Consent for Diagnosis and Treatment, Authorization and Release Forms

  • Spanish versions of the form are available here

Child Maltreatment Protocol

CMP Billing Statement