Designing your form is an important part of the process when submitting a new claim to workers' compensation. In order to ensure that you are completing all of the required forms and providing the correct information, it is important to understand the Cy47 Form. This form is used to report injuries that occurred in California, and must be filled out by both the employer and employee. By understanding how to complete this form correctly, you can ensure a smooth processing of your claim.
| Question | Answer |
|---|---|
| Form Name | Cy47 Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | cy47, childline report form, cy47 form, cy47 online form |
The CY 47 Form
As mandated reporters of suspected child abuse and neglect, EMS providers are required to submit a CY 47 form to the county Children and Youth agency within 48 hours of making the oral report to the statewide hotline, called ChildLine. Please complete as much as possible on the CY 47. You may have very little information on the family but you are still required to complete what you can and submit the form. If another mandated reporter i.e. emergency room nurse also makes a report of suspected abuse to ChildLine on the same family, that person will also complete and submit a separate CY 47 form. It is important to list your name and phone number on the CY 47 if the Children and Youth investigator has additional questions for you. This contact information can not be shared with anyone except if law enforcement must be notified; then the reporting source is treated as a confidential informant. Additional CY 47 forms are available by contacting ChildLine.
Follow the basic guidelines in reporting suspected child abuse and neglect:
•Call ChildLine as soon as possible with the oral report
•Complete a CY 47 and mail to the county Children and Youth agency
Follow Up
If it has been at least 30 days since the report of suspected abuse, the mandated reporter may contact the county Children and Youth investigator to find out:
•The outcome of the investigation
•What, if any, services are being provided or arranged for the family