Liquid Listening Concern Form

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This form is where you can share any wellbeing and/or safeguarding concerns / incidents, no matter how small they may seem, with the Liquid Listening Safeguarding Leads (DSLs), Judith Robinson (Executive Director) and Joel Cahen (Artistic Director and Project Manager).

If you have any difficulties completing this form please contact Judith on judith@liquidlistening.org or 07903 369903.

If your concern is about a Liquid Listening Designated Safeguarding Lead (DSL) please contact:

Liquid Listening Safeguarding Trustee, Lorna Crust, on aquakids@icloud.com
Or call your Local Authority Designated Officer (you can call the NSPCC on 0808 800 5000 to find out how your Local Authority Designated Officer is, if you don't know).

Part 1: Information about the person reporting the concern / incident

1. Your full name *

2. Your email address *

3. Your phone number *

4. Name of the person you have a concern about *

5. Date of incident / concern *

YYYY

6. Place of incident / concern (please be specific). *

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