Child Safety Complaint Form

Child safety is everyone’s responsibility, so whether you are a child, parent or member of the community, we want to hear from you if you have seen, heard or experienced something that has caused concern or distress.

We will treat every complaint with respect and confidentiality. Please provide as many details as possible so we can follow up on your report.

About You

Name

Mobile

Are you under 18 years old? (If yes, please provide your parent’s details below. Please note that we are unable to contact you without parental permission.)

Yes No

Your Parent's Name

Your Parent's Email

About the affected child or young person

Please provide as many details as possible

Name

Mobile

Gender

Age

Your relationship to this child or young person (parent, sibling, friend, bystander, etc.)

Tell us about the complaint

Please include as much information as possible, such as:
names of people involved, their role/s at Crossway, date and place of incident, witness details, description of any injury, behaviour or abuse observed.
If the child or young person has made a report to you, please record it in their own words, if possible.

More about the affected child or young person

Do they identify as Aboriginal/Torres Strait Islander?

Are they from a culturally and/or linguistically diverse background?

Do they have a disability?

Do they identify as LGBTQIA+?

Are they in out-of-home care?