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SLKT Safeguarding Concern Form
Please use this form to report any concerns you have about the welfare of a child or adult who is connected to St Luke's Church Oseney Crescent.
If you have a MyConcern account, please report it there:
https://login.thesafeguardingcompany.com/
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* Indicates required question
Email
*
Your email
Name of the person you're concerned about
*
Your answer
A brief summary of the concern
*
Your answer
Contact details of the person (if known)
Your answer
Date of birth (or estimated age)
*
Your answer
Date of the incident
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MM
/
DD
/
YYYY
Time of the incident
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Time
:
AM
PM
Location of the incident
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Your answer
Ministry Link
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Kids or youth (under 18s)
Sunday service, including prayer ministry
Other SLKT events (Alpha, Streams, Simple Supper, etc)
Wider community
Other:
Concern
Please give a full detailed description of the concern including the presentation of the person (physical appearance, emotional state, behavioural marks). Use their words as much as possible and don't interpret the information
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Your answer
What action (if any) did you take?
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Administer First Aid
Contact Emergency Services
Contact Social Care
Pass on concern verbally to activity leader
Speak to parent or carer
Other:
Required
Your name
*
Your answer
Your preferred contact method (phone number or email address)
Your answer
By submitting this form you are confirming that the above information is an accurate and true reflection of the incident, and that you are happy for us to contact you regarding this incident.
*
Yes
Required
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