Tell Us What's Wrong
This form is to help you report any worries or safeguarding concerns. This information will go to your school Headteacher. Please do not worry as information will be taken seriously. Please complete the following boxes so we can help you quickly.
Name
*
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Year Group
Reception
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
What can we help with?
*
I'm Feeling Sad
I'm Feeling Bullied
I'm Feeling Bad
I'm Feeling Upset
I'm Feeling Scared
I'm Feeling Lonely
I'm Feeling Unwell
I'm Feeling Worried
I'm Feeling Horrible
I'm Feeling Stressed
I'm Feeling Depressed
Please Type Your Message Below (you MUST fill in this section) Please Don't Use Abusive Words Or Bad Language
*
Please verify that you are human
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Submit
Should be Empty: