Report Abuse and Concerns

If you think someone is at immediate risk dial 999

I am concerned about *

The person you are concerned about if name known?

Their address (if known)

Why are you concerned about them? (Please give as much detail as possible) *

Can we contact you to discuss further if necessary?

Yes No

You do not have to give your contact details. It is however very useful to be able to speak to you if we feel we need further information and if appropriate to give you feedback.

Your name (optional)

Your address (optional)

Your telephone (optional)

Your email (optional)

Confidentiality Statement

Any information you provide on this form will be held by Southampton City Council in accordance with the Data Act 1988. The City Council's nominated representative for the purpose of the Act is Mark Heath, Solicitor to the Council. The information you have provided will be used for the purposes of monitoring and data analysis. Information will be kept confidential and not transferred to any third parties except where we are required to do so under legal duty or for the purposes of the prevention or detection of crime or for the apprehension or prosecution of offenders.