report child abuse

To all doctors: If you witness a case of child abuse please inform your senior about the existing reporting guidelines from the Ministry of Health and fill out this form with the appropriate information. Reports are to be sumitted to the following individuals from the Ministry's committee.

Al-Sabah Hospital: Dr. Nada Al-Terkait
Mubarak Al-Kabir Hospital: Dr. Muneera Al-Hajry
Amiri Hospital: Dr. Jawad Al-Momen
Al-Jahra Hospital: Dr. Mohamad Mazen
Farwaniya Hospital: Dr. Majdy Helmy
Adan Hospital: Dr. Aty Anaam Alhaq
Primary care: Dr. Rehab Al-Watyan*Time & Date: Registration place*hospital: Clinic: School: Others: Address & contacts phone no.:
*ID NO. Of victim: Place of Event: *Age of the victim-date of birth: *sex: Legal guardian of the child: Type of Abuse/neglect:physical: Sexual: Psychological: Others: Details of event: *Repeated event? If it Yes- No. Investigation done: blood (&results)
X-ray. Skeletal survey. u/s.C-T Others:
Action done:medical treatment (full report)
Social worker report: *Police involvement:: Court case no.: Injuries to a sibling (If Any):
Per traitor : or suspected abuser:
Follow up:
Comments: