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Child Safety & Safeguarding Report Form

St John Safeguarding Concern & Complaint Report Form

St John Ambulance Victoria is committed to continuously improving our safeguarding practices and we welcome any feedback or formal complaints which you wish to make. If you wish to add to this complaint or follow up its progress you can email childsafety@stjohnvic.com.au

Where somebody is in immediate danger, contact triple zero (000) and contact a St John child safety officer on 03 9483 4386

If you are a youth member or child, you should use the use friendly version of this form, available at - Youth Complaint & Reporting Form

Name of the person completing this form

Your email address

Your best contact number (Number)

I am a *

Employee of St John
Adult Volunteer with St John
Parent or Carer
Adult Member of the community
Contractor to St John
Youth Member
Other (not listed above)

Name of the young person this issue involves (if relevant)

Your relationship to the young person this issue involves (if relevant)

Date of incident or date you became aware of the issue

Have you reported this issue to anyone within St John or to an external authority ?

Tell us what has happened

When are where did it happen?

Who was involved and are there any witnesses?

What actions (if any) have you taken?

Any other comments or things you think we should know?

Would you like someone to contact you about this report?

Yes

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