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Reporting a Safeguarding Concern

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Safeguarding Concern Portal Referral for Professionals

Please login/register below prior to completing the form:
In order to progress with this form you must either log in or complete a simple registration for a new account. You can then continue to complete this form. This will enable you to track the form at a later date.
Please give details of individual raising this concern

Relationship to the individual * This field is required

Who is to be contacted to discuss this Safeguarding Concern? * This field is required
Details of adult at risk
Does the individual identify with the gender they were given at birth?

Marital status

Other relevant relationships:
Is there an identified Nearest Relative under the Mental Health act? * This field is required
Is there a Lasting Power of Attorney for Health and Wellbeing/Financial? * This field is required
Is there a named court appointed deputy? * This field is required
Is there an identified next of kin? * This field is required
Please note that to enable us to progress your enquiry effectively, we will require details of your GP.
Is the individual placed by another authority? * This field is required
Nature of funding arrangements for care provided at time of incident * This field is required
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