The Safeguarding Incident Report Form Template UK is offered in multiple formats, including PDF, Word, and Google Docs, featuring customizable and printable samples.
Safeguarding Incident Report Form Template UK Editable – PrintableSample
Safeguarding Incident Report Form Template UK 1. Incident Reporting Information 2. Reporting Individual’s Information 3. Individual(s) Involved in the Incident 4. Description of the Incident 5. Witness Information 6. Actions Taken and Follow-up Measures 7. Reporting and Notification 8. Recommendations for Future Prevention 9. Signatures and Agreement 10. Declaration
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Examples
Date of Incident: [Date]
Time of Incident: [Time]
Location of Incident: [Location]
[Name of the Person Reporting]
[Position/Role]
[Contact Information]
[Name of the Alleged Victim]
[Details of Alleged Victim, e.g., age, relationship to organization]
[Name of the Alleged Perpetrator]
[Details of Alleged Perpetrator, e.g., age, relationship to organization]
[Provide a detailed description of the incident, including what happened, when, and where. Include any actions taken immediately after the incident occurred. Be specific about the events and context.]
[List any witnesses to the incident, including names and contact details.]
[Describe the actions taken immediately following the incident, such as reporting to authorities, providing care, etc.]
[Outline any necessary follow-up actions that need to be taken, e.g., referrals to safeguarding teams, additional investigations, etc.]
[Provide a summary of conclusions drawn from the incident and recommendations for further preventive measures or changes to policies.]
[Signature of Person Reporting]
[Date of Report]
Date of Incident: [Date]
Time of Incident: [Time]
Location of Incident: [Location]
[Name]
[Position/Role]
[Contact Information]
Victim: [Name][Age]
Perpetrator: [Name][Age]
[Any relevant background information about the individuals involved]
[A detailed account of the incident, including circumstances surrounding it, how it was discovered, and the response made. Include quotes or statements if relevant.]
[List names, contact details, and statements from any witnesses present during the incident.]
[Describe steps that were taken to address the situation, including notification of safeguarding officers, medical assistance provided, etc.]
[Detail any follow-up actions that need to be taken, which can include referrals to mental health services or additional training for staff.]
[Summarize findings and provide suggestions for policy or procedural changes to enhance safeguarding practices.]
[Signature of Reporting Individual]
[Date]
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