Parish of Holy Trinity & Christ Church, Richmond Cause for Concern Form
As stated in Holy Trinity Church's Safeguarding Policy, this form will be sent directly and privately to the Parish Safeguarding Officers (PSOs): Anke Marais and Graham Bamping.

Please record any concerns you notice or are disclosed about a child, young person or vulnerable adult. Please be specific and record facts only. Make a note of your observations as soon as possible after the event. Do not investigate yourself or make promises that you cannot keep. All details are to be kept confidential.

If you have immediate concerns about the safety of someone, contact the Police on 999. Alternatively, contact Children's Social Services: SPA (Single Point of Access) on 020 8547 5008 (8am to 5.15pm Mon to Thurs and 8am - 5pm Friday) or 020 8770 5000 (out of hours) or Adult Social Services: 020 8891 7971 (Mon to Fri 9am to 5pm) or SMS Phone: 07903 738043 or email: adultsocialservices@richmond.gov.uk

Sign in to Google to save your progress. Learn more
Email *
Full name of person who is the subject of concern: *
Type of person this concern is about: *
Is this person a child, young person, vulnerable adult, or adult?
Date of birth/age if known: *
Date of concern: *
Date concern recorded: *
Category of concern: *
Required
Nature of concern: *
Who, what, when, where, how, why?
Full name of person reporting: *
Email address of person reporting: *
Phone number of person reporting: *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Holy Trinity Richmond.

Does this form look suspicious? Report