Child Safety Concern Reporting

Your Safety Matters

If you or someone are in immediate danger or needs urgent help, call 000.

If something has happened that made you feel unsafe or worried, or you're worried about someone else, you can tell us here.

This form goes directly to the Shire of Capel's Child Safety Officer only. They are not part of the Youth Services team, and their job is to help keep children and young people safe.

You can complete this form yourself, or ask a trusted adult to help you.

Save Your Progress

You have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address.

Email Address:

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Password:

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 There is no way to resend or recover your password, please write it down.

Note: Incomplete forms are kept for a period of 2 day(s), after this time the system will automatically delete your response.

Your Safety Matters!

Please tell us what has happened:

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Your Details

You have the option to remain anonymous. Otherwise, please include your name and contact details below:

Name

Phone Number

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Email Address

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