Form Runner


You can use this form to tell us if you think that you or another adult is being abused or neglected.

This is the form for the public, if you are a professional and want to contact us about safeguarding, use a safeguarding online form for professionals.

By law, we need to follow up any abuse and neglect reported to us. You can help us do this-  It doesn’t matter if you cannot give us all the information, or if you feel unsure about what type of abuse you are reporting, any information you can provide will be helpful.

This form is only for concerns where there is no immediate danger. If you have immediate concerns about your own or someone else’s safety, call the Police on 999.

If this isn't an emergency but a crime may have taken place, call the Police on 101.

If you are not sure, fill in the form or call Care Direct 0117 922 2700 and we'll get back you.

Are you a professional or member of the public?
Missing or incorrect value

13:10, 26/01/2020
Did the *abuse happen in Bristol?
You need to tick one of the options.*This may also apply to neglect, exploitation or risk of harm

You want to report a safeguarding concern about
You need to tick one of the options.

Write dd/mm/yyy
Did the incident happen more than once?
You need to tick one of the options.
What type of abuse are you concerned about?You need to tell us what type of abuse you're concerned about.Select as appropriate, you can choose more than one.
You need to describe the event.Write as many details as possible.
Where did the abuse happen?
You need to tell us what type of establishment is this.

Are you aware of any past concerns?
You need to tick one of the options.
Is there anything else that we should be aware of?
Such as a dangerous pets

Is there anyone else we should talk to about the concern?
You need to tick one of the options.

We are committed to making equal opportunities a reality in the provision of all of our services. We need to know who our
customers are to check that everyone in the city is accessing the services they are entitled to and that no-one is discriminated against
unlawfully. Information provided will be treated confidentially and in accordance with the Data Protection Act 1998 and only used to ensure that
everyone is treated fairly.

What is your/their gender?
You need to tick one of the options.
Sexual orientation
You need to tick one of the options.
You need to tick one of the options.
Choose "don't know" if you're not sure

Check the information you've entered before you submit the form.

Once you have submitted the form you will NOT receive a confirmation email. 

You can edit the form using the back button at the bottom of the page.

Once you submit this form, it will go to our Safeguarding Team who will look at it and take any action needed.  

If you need to contact us on 0117 922 2700.

Found draft
Found draft
Found drafts
Existing form data found
Form Submitted
Review Form Validation Messages
Unable to complete action