Safeguarding Incident Report Form Template UK

The Safeguarding Incident Report Form Template UK is offered in multiple formats, including PDF, Word, and Google Docs, featuring customizable and printable samples.


Sample

Safeguarding Incident Report Form Template UK

Editable – Printable



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



PDF


WORD

Examples


Safeguarding Incident Report Form Template UK (1)
Incident Details:
Date of Incident: [Date]
Time of Incident: [Time]
Location of Incident: [Location]
Reported By:
[Name of the Person Reporting]
[Position/Role]
[Contact Information]
Involved Parties:
[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]
Description of Incident:
[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.]
Witnesses:
[List any witnesses to the incident, including names and contact details.]
Immediate Actions Taken:
[Describe the actions taken immediately following the incident, such as reporting to authorities, providing care, etc.]
Follow-Up Actions Required:
[Outline any necessary follow-up actions that need to be taken, e.g., referrals to safeguarding teams, additional investigations, etc.]
Conclusions and Recommendations:
[Provide a summary of conclusions drawn from the incident and recommendations for further preventive measures or changes to policies.]
Signed by:
[Signature of Person Reporting]
[Date of Report]
Safeguarding Incident Report Form Template UK (2)
Incident Overview:
Date of Incident: [Date]
Time of Incident: [Time]
Location of Incident: [Location]
Reporting Individual:
[Name]
[Position/Role]
[Contact Information]
Individuals Involved:
Victim: [Name][Age]
Perpetrator: [Name][Age]
[Any relevant background information about the individuals involved]
Incident Narrative:
[A detailed account of the incident, including circumstances surrounding it, how it was discovered, and the response made. Include quotes or statements if relevant.]
Witness Information:
[List names, contact details, and statements from any witnesses present during the incident.]
Actions Taken Post-Incident:
[Describe steps that were taken to address the situation, including notification of safeguarding officers, medical assistance provided, etc.]
Follow-Up Required:
[Detail any follow-up actions that need to be taken, which can include referrals to mental health services or additional training for staff.]
Summary and Future Recommendations:
[Summarize findings and provide suggestions for policy or procedural changes to enhance safeguarding practices.]
Confirmation:
[Signature of Reporting Individual]
[Date]

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Safeguarding Incident Report Form Template UK