Cants 5 Form – Fill Out and Use This PDF

Updated: Nov 2, 2026

The CANTS 5 form, officially known as the Written Confirmation of Suspected Child Abuse/Neglect Report for Mandated Reporters, is a crucial document used by the Illinois Department of Children and Family Services. It serves to formalize the process of reporting suspected child abuse or neglect by mandated reporters following an initial oral report. This ensures that the appropriate actions can be taken to protect children in potentially harmful situations. For detailed assistance on how to properly fill out and submit this form, click the button below.

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Cants 5 Form PDF Details

The CANTS 5 form is the official Written Confirmation of Suspected Child Abuse/Neglect Report, used by mandated reporters in Illinois to document child abuse or neglect after making an initial oral report to the Illinois Department of Children and Family Services (DCFS). Under the Abused and Neglected Child Reporting Act (325 ILCS 5 et seq.), mandated reporters must submit this written confirmation within 48 hours of their telephone report to the DCFS Child Abuse Hotline.

Who Must File the CANTS 5 Form

Illinois law designates specific professionals as mandated reporters who are legally required to report any reasonable suspicion of child abuse or neglect. These individuals include teachers, school administrators, physicians, nurses, social workers, law enforcement officers, child care workers, and mental health professionals. Once a mandated reporter contacts the DCFS Child Abuse Hotline at 1-800-25-ABUSE, they must follow up with a completed CANTS 5 form submitted to their local DCFS office within 48 hours.

Information Required on the CANTS 5 Form

The CANTS 5 form collects detailed information to support a thorough child protection investigation. Reporters must provide the child's name, birth date, and address along with a clear description of observed injuries or signs of neglect. The form also requires the approximate date and circumstances of the suspected abuse, names and addresses of parents or guardians, any prior evidence of maltreatment, and whether the reporter has notified or plans to notify the child's family. The reporter's professional title, organization, and contact information are required as well.

Submitting the CANTS 5 Form

After filling out the CANTS 5 form, submit it to the appropriate Illinois DCFS office by mail or in person within 48 hours of the oral report. Keep a copy for your professional records as required under Illinois law. For related Illinois child welfare documentation, review the DCFS 561-B form and the DCFS CW CPI-2 form, both used in related child welfare proceedings in Illinois.

Question	Answer
Form Name	Cants 5 Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	dcfs cant 5 form, cants 5, cants5, cant 5 form

How to Fill Out Cants 5

Cants 5 at a glance

What it is: CANTS 5, State of Illinois Department of Children and Family Services: written confirmation of a suspected child abuse/neglect report.

Where and when to file: Mail the original to the nearest office of the Illinois Department of Children and Family Services, Attention: Child Protective Services.

The Abused and Neglected Child Reporting Act states that mandated reporters shall promptly report or cause reports to be made in accordance with the provisions of the ACT.

A filled-in Cants 5 example: a school nurse confirms her oral report

Cants 5 example filled out, example: a school nurse confirms her oral report — Jane Sample, a school nurse, fills out Cants 5 to confirm her oral report about one child. She answers No to question 3, so question 4 stays empty. The picture shows page 1, and every value in it is made up. Jane saw the child, has not told the family, is willing to tell them, and does NOT believe the child is in immediate physical danger, so From whom stays empty. She reports one child, so 2nd Child's Name (If Any) stays empty.

How to fill out Cants 5, box by box

Child, Parent/Custodians and the questions

Fill in the Date, the child's Name and Birth Date, the Street Address, City and Zip Code, and the Parent/Custodians Name and Address (if different than the child's address). If you are reporting more than one child from the same family please list their names and birth date in the space provided on the reverse side of this form (page 2). This is to confirm my oral report of , , made in accordance with the Abused and Neglected Child reporting Act (325 ILCS 5 et seq). Please answer the following questions. (If you need more space, use the back of this page (page 1).) 1. What injuries or signs of abuse/neglect are there? 2. How and approximately when did the abuse/neglect occur and how did you become aware of the abuse/neglect? 3. Had there been evidence of abuse/neglect before now? Yes No 4. If the answer to question 3 is "yes," please explain the nature of the abuse/neglect. 5. Names and addresses of other persons who may be willing to provide information about this case. 6. Your relationship to child(ren) 7. Reporter Action Recommended or Taken.

2nd Child's Name (If Any)

Fill in the 2nd Child's Name (If Any), 2nd Child's Birth Date, 3rd Child's Name (If Any), 3rd Child's Birth Date.

I saw the child(ren) or I heard about the child(ren), the family and danger

Mark one: I saw the child(ren) or I heard about the child(ren), From whom? I have or have not told the child's family of my concern and of my report to the Department. I am willing or NOT willing to tell the child's family of my concern and of my report to the Department. I believe or do NOT believe the child is in immediate physical danger. Then add (Name Printed) and (Signature).

Title and Organization/Agency

Add your (Title) and (Organization/Agency).

Common questions about Cants 5

Is there a deadline?

The report should be made immediately by telephone to the IDCFS Child Abuse Hotline (800-252-2873) and confirmed in writing via the U.S. Mail, postage prepaid, within 48 hours of the initial report.

Where do I file it?

Mail the original to the nearest office of the Illinois Department of Children and Family Services, Attention: Child Protective Services.

Sources

[1] Cants 5 (Rev. 10/00), Written Confirmation of Suspected Child Abuse/Neglect Report, Illinois Department of Children and Family Services (the Official source link on this page).