Responses are monitored by our safeguarding team. They will take appropriate action in line with our safeguarding policies and procedures which can be found on our website.
Details of person at risk:
Full name of young person/people at risk:
Session location:
London
Other/Not sure
Manchester School:
London School:
Please provide any additional details that can help us to understand the location of the young person/people at risk:
Details of concern/incident:
Date of incident:
Nature of concern
Choose which best describes your concern or write in another option:
If other, enter your answer here:
Who else witnessed or was involved with the incident? (if applicable)
Please include full names, roles and organisation (e.g. name of school or agency).
Please give a full description of what was noticed, said or disclosed
Quote the exact words used where possible
Include times and dates where relevant
Stick to the facts and avoid sharing your opinion
What action did you take?
Anything you said to the young person, other mentors, Project Leader etc.
Your full name:
Email
Our safeguarding team will let you know they've received your concern and update on any action as appropriate.
Your role:
Other Volunteer or coach
Youth Development Lead
Other ReachOut Staff Member
Parent/Carer
Other
Is there a Youth Development Lead or ReachOut Staff Member there with you now?
If so, they will now be asked to complete the remainder of the form to detail any additional action taken.
Yes
No
Please enter the Enrolment Number of the primary young person at risk:
Example: M12345Note: please only put one Enrolment number as written above and no other text, as the form will not recognise more than one enrolment number. The DSL(s) actions will involve all mentees named in earlier sections of the form.If your concern involves an adult without an enrolment number, please enter 'M00000' - you will receive an error message on the next page but it has likely still come through to our system. Please email safeguarding@reachoutuk.org or phone the DSL(s) to confirm it has been received.
Press submit once the form is complete.
Please use the back button to read over the report provided - is there any additional context or information to pass on?
This is to ensure we have an accurate report and you will be able to add detail of the action you took in the next question
Action taken by Youth Development Lead
e.g. TED talk and further information/ insight gained from this (including names, dates, times)
If passed straight onto RO staff please detail this here
Reason for decision on action taken:
Your name
Contact Information