Safeguarding Form

Feedback Form

What would like to give feedback or inform us about today? *

Please Select

Please let us know the name, address and contact details of the person you are concerned about: *

Please confirm if you have spoken to the person about your concerns and they know you are contacting us? *

Yes

Please can you let us know details of your safeguarding concerns below: *

Would you be happy for us to contact you in reference to this concerns? *

Yes

Your contact details: *

What is the Health and Safety Concern?: *

What property or service does this relate to?: *

Would you be happy for BCHA to contact you regarding the information you have provided? *

Yes

Your contact details: *

Please let us know your feedback?: *

What property or service does this relate to?: *

Would you be happy for BCHA to contact you regarding the information you have provided?: *

Yes

Your contact details: *

Please ensure this form is fully completed and signed, as we may be unable to proceed without the information. Once received, we will contact you to discuss. *

By signing this document, I agree with BCHA’s Privacy Notice and give consent for BCHA to share any of the above information with third parties if a risk is disclosed. *

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Bournemouth Churches Housing Association Limited is a charitable registered society under the Co-operative and Community Benefit Societies Act 2014, registered with the Financial Conduct Authority No. 18497R and with the Homes and Communities Agency No. LH0155. The Factory, 14 Alder Hills, Poole, BH12 4AS

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