DIOCESE OF DUNKELD - ONLINE REPORTING FORM

DIOCESE OF DUNKELD

Allegation and Concern Recording Form

STRICTLY CONFIDENTIAL

If you have concerns about a child or vulnerable adult's safety or wellbeing within one of our parishes the following form will allow you to raise those concerns with the Diocese.

Or if you are a survivor of abuse by someone within the Catholic Church and wish to inform the Diocese of your experience this form can also be used for that purpose.

PLEASE NOTE: This form should NOT be used in emergencies. If you think a child or vulnerable adult is in immediate danger you should phone the Police on 999

The Catholic Church in Scotland has a mandatory reporting policy for all allegations of abuse. This means that ALL are reported to the Police, whether the person against whom the allegation is made is alive or deceased.

Although all allegations are reported to the Police, you have the right to decide whether or not to engage with the Police at this stage. If you wish to make a statement to the Police, or if you decide that you are unable to do so at the moment, Safeguarding personnel are still available to offer you support.

Although shared with the police, any allegation or concerns raised will be held with the strictest of confidence. Only those senior members of the Diocese within the Safeguarding Dept. including the Bishop will be informed of your contact.

What We Need From You

Please say as much as you can about the situation to help us take the right action. You should tell us what you yourself have seen and heard giving examples where you can.

You can make an anonymous referral but it is more helpful to have your contact details in case we need to check something out or ask for more information.

PLEASE USE THIS FORM FOR REPORTING:

A SAFEGUARDING CONCERN - relating to a Church activity or to Church personnel which may arise from the observation of the conduct of Church personnel/volunteers, or from worrying signs in the behaviour or appearance of a child or vulnerable adult.

AN ALLEGATION OF ABUSE - relating to a Church activity or to Church personnel of the abuse of a child or vulnerable adult, either recently or in the past by a bishop, priest, religious, seminarian, Church employee or volunteer.

TO CONTINUE TO COMPLETE THIS FORM PLEASE PRESS NEXT BELOW

Your Details
Providing us with your contact details*

I am happy to share my contact details with the Diocese of DunkeldI would prefer to keep my details anonymous
Please proceed to the next page
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Email*
example@example.com

DETAILS OF ALLEGATION or CONCERN
Please provide details about the person who has been abused or that you are concerned about*

I am the person named on the previous page or reporting anonymouslyI am reporting about someone else
Please proceed to the next page
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal Code
Phone Number

Area CodePhone Number
Age (known or approx.)
Is the person whose information you have shared above aware that you are making this disclosure?*

Yes the person is aware that this disclosure is being madeNo the person is not aware that this disclosure is being made

PERSON ALLEGED RESPONSIBLE FOR HARM
Name*

First NameLast Name
Position (within the church)*
Parish or Diocese (If known)*
Address (if known)

Street Address

Street Address Line 2

CityState / Province

Postal Code
Phone Number (If known)

Area CodePhone Number

DETAILS OF ALLEGATION or CONCERN
Please tell us when the allegation or concern took place: *
(Approximate dates are sufficient if you are unsure of exact dates)
Please say as much as you can about the situation to help us take the right action. You should tell us what you yourself have experienced, seen and/or heard giving examples where you can.*
(This text box will expand as required)

The Diocese of Dunkeld thanks you for taking the time to complete this form. We do not underestimate the courage it may have taken you to come forward to tell us of your experience or to share your concern. Please be assured that you will be treated with the utmost respect and compassion.

At all points we will listen carefully to what you have to say and will taken seriously.

WHAT WILL HAPPEN NEXT

The information you share will be send directly to the Diocesan Safeguarding Advisor whose role it it to support the Bishop with management of safeguarding issues.

The Diocesan Safeguarding Advisor (or a member of the Diocese Safeguarding Team) will read your report and make contact with you as soon as is possible.

The information you provide will be shared with Bishop (if appropriate)

The Diocesan Safeguarding Advisor will contact you (if details have been shared) and you will be invited to meet to discuss the detail of your report.

The location and people present at this meeting will be your choice. You may wish to speak with only a female or you may wish to have spouse or friend present.

MANDATORY REPORTING

The Catholic Church in Scotland has a mandatory reporting policy for all allegations of abuse. This means that ALL are reported to the Police, whether the accused is alive or deceased.

Although all allegations are reported to the Police, you have the right to decide whether or not to engage with the Police at this stage. If you wish to make a statement to the Police, or if you decide that you are unable to do so at the moment, Safeguarding personnel are still available to offer you support.
I wish to be contacted from the Diocese by:*

A FemaleA MaleNo preference

Thank you for taking the time to report your experience or raise

your concern with the Diocese of Dunkeld.

Please review or print your submission by using the buttons below.

When you submit this form your form it will be sent directly to the inbox of the Diocesan Safeguarding Advisor.

The contact details for the Safeguarding Advisor are:

John Smith

Diocese of Dunkeld Curial Offices,

30 Lawside Road,

Dundee, DD3 6XY

Tel. 01382 225453 (Option 5)

Thank you for deciding to tell someone about your experience or concern.

We understand that for anyone to reach this point demands significant courage.
Should be Empty:

Your Details

DETAILS OF ALLEGATION or CONCERN

PERSON ALLEGED RESPONSIBLE FOR HARM

DETAILS OF ALLEGATION or CONCERN