Recording Form for Safeguarding Concerns Staff, volunteers and regular visitors are required to complete this form and pass it to DSL: Emma Samue,l if they have a safeguarding concern about a person on our projects. Information Required
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Full name of child Full name of adult Date of birth Your name and position Nature of concern/disclosure Please include where you were when the individual made a disclosure, what you saw, who else was there, what did the individual say or do and what you said. [Ensure that if there is an injury this is recorded (size and shape) and a body map is completed] [Make it clear if you have a raised a concern about a similar issue previously]
Time & date of incident: Name and position of the person you passing this information to? Your Signature Time and date form completed
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