Other please describe: – If the concern is associated with an injury please give details here and draw location of injury on the body map. If the cause for concern is any of the other above reasons or are in addition to an injury please give details here: Did the pupil say, sign or gesture anything? If so please give exact details including any response you made to the pupil. Are there any other details relevant to your concerns? E.g .Have there been any changes in the pupil’s life? Have you taken any other action not described above? Have you discussed your concern with anyone else? Yes No If yes please state who: Reporters signature: Received by DCPC: Date: Date: Action agreed with DCPC:
Other – please describe: If the concern is associated with an injury please give details here and draw location of injury on the body map. If the cause for concern is any of the other above reasons or are in addition to an injury please give details here: Did the pupil say, sign or gesture anything? If so please give exact details including any response you made to the pupil. Are there any other details relevant to your concerns? E.g .Have there been any changes in the pupil’s life? Have you taken any other action not described above? Have you discussed your concern with anyone else? Yes No If yes please state who: Reporters signature: Date: Received by DCPC: Date: Action agreed with DCPC:
Child%20Protection%20Policy%20Jan%202014.docx