Chapter 394 of the Laws of 2014 require personal representatives to be notified when a service recipient will be interviewed as part of an abuse and neglect investigation. This form is an optional template to document that this notification has occurred.

Personal representatives of alleged victims shall be notified of the intent to interview within 24 hours and personal representatives of potential witnesses shall be notified of the intent to interview within 48 hours. At the request of the Justice Center or the delegate investigatory entity, the service provider shall provide the investigator with pertinent information necessary to safely conduct an interview. Providers may use this form to comply with this requirement.

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