Safeguarding Disclosures and Concerns Reporting

Please use this form to report/record any safeguarding disclosures that relate to one of the churches of the Cornerstone Collective and its people.

The information you provide will be stored and dealt with in the strictest confidence, and all details will be inaccessible to anyone other than the safeguarding team, apart from your name and email address at the start of the form, which may be viewable to a small number of other people in the Collective.

If you would rather remain anonymous or not have your details visible to anyone other than the safeguarding team, please put 'anonymous' (or similar) in the name and email address fields at the start, but add your details in the 'any other relevant details' section later on if you are comfortable with the safeguarding team knowing who has completed the referral.

Knowing this information will help the safeguarding team deal with disclosures more efficiently and robustly.

Your name *

Email address *

Name of the person making the disclosure *

This may be yourself, or you may be making this on behalf of somebody else.

Name(s) of the person/people the safeguarding disclosure relates to *

Date of the safeguarding concern/disclosure first occurring *

Nature of the safeguarding disclosure/concern *

Please provide an overview of the safeguarding concern/disclosure. Details here will be very helpful to the safeguarding team as they work to investigate and address the disclosure.

Any other relevant details

This may be where you are comfortable with providing your name/email address as the person completing the form (for complete anonymity outside of the safeguarding team), it may be where you tell us who else is aware of the safeguarding concern or something else which you feel is important for us to know.

Is the person/are the people that this safeguarding disclosure relates to aware that you are completing this form? *

If there is more than one person involved, please state who is/isn't aware.

Please tick this box to confirm you have read and understood the Privacy Policy of Cornerstone Collective of Churches, and to confirm your consent for us to store your data in line with GDPR. We commit to respecting your data and storing it securely at all times.

Contact permissions *

Please select from the options below regarding your consent for Cornerstone Collective of Churches to contact you using the details you have provided to us

Yes

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