Child protection concern forms

Take a look at examples of safeguarding forms for recording child protection concerns and disclosures, from a local authority (LA) and schools. Plus, find template spreadsheets to download and use to track concerns and referrals in your school.

Last reviewed on 7 February 2024See updates
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  1. Example from a local authority
  2. Examples from schools
  3. Track the progress of child protection concerns

Example from a local authority

Essex County Council has a template for the report of a concern for child protection. It includes space to record details such as: 

  • The date of both record and incident 
  • The name and role of the person making the referral 
  • Details of the concern, using a body map if appropriate (you can also download a body map template from the link above) 
  • Action taken and advice sought
  • Whether a referral was made

Examples from schools

Voluntary controlled (VC) primary school

St Peter's Church of England Primary School (VC) in the city of Bristol has a safeguarding concern form which has space to indicate:

  • Whether the person completing the form is a pupil, member of staff, or parent/carer
  • Whether they witnessed or experienced an incident themselves, or was told about one
  • Details about the concern

Secondary school 

The contact details of the person reporting the concern The

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