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England Handball Safeguarding Incident report
This form is for the reporting of safeguarding concerns/disclosures happening with the England Handball sphere of influence relating to club/member activity.
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* Indicates required question
Email
*
Your email
Name of Individual completing form
Your answer
Telephone
Your answer
Name of Child/Adult affected (or multiple)
Your answer
Location of incident
Your answer
Date of Incident
MM
/
DD
/
YYYY
Time of Incident
Time
:
AM
PM
Are you reporting your own concern or that of another party
Own perspective
Other party
Other:
Clear selection
Nature of incident
Your answer
Type of incident
Neglect
Physical Abuse
Sexual Abuse
Poor Practice in Sport
Emotional Abuse
Bullying
Other:
Clear selection
Report the facts as you observed them i.e. Behaviours, visible injuries.
Your answer
Person of concern
Your answer
Summary of the Child Account of the incidents (if available)
Your answer
Details of any witness to the incidents (include names and contact details)
Your answer
Details of any actions taken, including anyone else that has been consulted, with names, contact details and advice received.
Your answer
Have the child Parents been contacted
Yes
No
Maybe
Clear selection
If yes, What has been said?
Your answer
Send me a copy of my responses.
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