Safeguarding  & Prevent Alerter Form 2022
This form is to be used to record the basic information in the light of an allegation, suspicion or disclosure of a safeguarding or prevent concern.  Completing this form should not stand in the way of you contacting a member of the designated safeguarding team directly.
Once you have submitted this form, a member of the Safeguarding team will contact you directly within 48 hours.
Do not discuss this incident with anyone other than who needs to know.

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Email *
Staff Name (First name and Surname) *
Sector Manager Name *
What sector does this relate to? *
Which of the following does your report relate to *
Site details (Name, postcode, telephone number)
Name of person/s this relates to: *
Date of the incident *
MM
/
DD
/
YYYY
Time of the incident *
Time
:
What have you seen and/or heard? (do not lead, do not probe, record facts) *
Action taken so far, confirm consent for DSL to contact, provide phone number and best time to contact *
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