Safeguarding Concern Form

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This form can be completed by anyone with a concern for a child or an adult at risk.

It will be sent immediately to the Designated Safeguarding Lead (Matt Savage) and the Deputy Designated Safeguarding Lead (Madeline Vosper) for Hedingham Baptist Church.

Name of child / adult of concern or at risk

Age or approximate age of the child / adult of concern or at risk

Name of person raising the concern *

Your telephone number *

Your email address *

Nature of the concern / incident *

Use the space below to write about the concern or incident, including: What happened? (Nature of concern/ disclosure made - use the person’s own words if known); When did it happen? (date, time); Where did it happen? (specific location); Who was allegedly involved and in what way? (include names of any potential witnesses).

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This form was created inside of Hedingham Baptist Church. Report Abuse

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