School Safeguarding Report Form
Use this form to report safeguarding concerns observed in the school environment. Please provide as much detail as possible.
Report Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your Role
*
Please Select
Teacher
Staff Member
Student
Parent/Guardian
Visitor
Other
Your Contact Information (email or phone)
*
Location Where Concern Was Observed
*
Date and Time of Incident or Concern
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Nature of Safeguarding Concern
*
Please Select
Physical abuse
Emotional abuse
Neglect
Bullying
Sexual abuse
Online safety concern
Other
Detailed Description of What Was Observed
*
Names and Roles of People Involved or At Risk
*
Immediate Action Already Taken (if any)
Additional Notes or Follow-Up Information
Submit Report
Should be Empty: