Report Child Abuse Form

If there are immediate concerns for a child a referral should be made immediately by telephone to the assessment service / duty team.  This form should then be completed and sent to the assessment team / duty team the same working day in accordance with all Wales Child Protection Procedures.  

PLEASE NOTE: This form will only be received during office hours

Please complete as fully as possible, especially ensuring that risks are identified.

  1. YOUR DETAILS

  2. SUBJECT OF REFERRAL:
    (Child, young person or unborn baby)

  3. NATURE OF CONCERNS:
    (including how and why those concerns have arisen)
  4. Click the button below to review & check your form then click 'Confirm' on the next page.
  5. Offensive terms within reports will be blocked and will not be received by us, these words can be masked using asterisks for example which will get through the filters.
Clear

Get in touch

Contact Us