Record of interviews with children as part of investigations conducted by Department of Child Safety, Youth and Women and/or Queensland Police Service on a [name of school or school authority] school site This form is to be completed by the Principal (or delegate) and retained confidentially at school level. File the form in a secure location with other school student protection documentation. School: Student to be interviewed: D.O.B.: Date of request: Time period within Immediate / today < 5 days 5 days - 14 days+ which contact is required Agency/agencies Department of Child Safety, Youth and Women intending to Queensland Police Service interview student Officers who are Name Position Agency requesting to interview the student Authority for Is the interview being conducted under the authority of section 17 of the Child Protection Act interview 1999? Yes - Interview may proceed without parental consent No - Interview must NOT proceed without parental consent
Record of interviews with children as part of investigations conducted by Department of Child Safety, Youth and Women and/or Queensland Police Service on a [name of school or school authority] school site This form is to be completed by the Principal (or delegate) and retained confidentially at school level. File the form in a secure location with other school student protection documentation. School: Student to be interviewed: D.O.B.: Date of request: Time period within which contact is required Immediate / today < 5 days 5 days - 14 days+ Agency/agencies intending to interview student Department of Child Safety, Youth and Women Queensland Police Service Officers who are requesting to interview the student Name Position Agency Authority for interview Is the interview being conducted under the authority of section 17 of the Child Protection Act 1999? Yes - Interview may proceed without parental consent No - Interview must NOT proceed without parental consent
20180405-Record-of-Interview-Form.docx