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Children and Families
Child Protection and Safety
The Duty and Child Protection Team Referral Form
Duty Referral form
Are you a member of the public or a professional?
Public
Professional
Referrer Detail
Please complete as much information as possible in order for the child/children to be identified to allow a referral to be progressed If child’s details are not identified this may prevent the referral to be progressed
Do you wish to remain Anonymous?
(optional)
Yes
No
Name
(optional)
Organisation
(optional)
Job Title
(optional)
Contact Number
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Email
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