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Safe Church Concerns Form

What is this document?

This document is a standardised intake form used by CCCVAT personnel and member churches to systematically record details whenever a concern, disclosure, or formal allegation of sexual abuse is reported.

It acts as the official data-gathering tool mandated by CCCVAT’s Sexual Abuse Claims Guideline to ensure consistent, accurate, and objective record-keeping.

Key Takeaways at a Glance

  • Mandated Intake Tool: Designed to be filled out during or immediately following a disclosure to ensure no key information is missed.

  • Role-Based Tracking: Captures the exact institutional status (employee, volunteer, attendee) of both the claimant and the accused to determine governance and reporting requirements.

  • Child Protection Safeguards: Automatically prompts for parent/guardian details whenever either the claimant or the accused was under 16 at the time of the alleged offence.

What’s Inside?

  1. Reporter & Context Details: Records local church information, date, time, and the contact details/role of the person completing the intake form.

  2. Claimant & Offence Information: Captures the victim’s details, dates/locations of alleged offences, description of the allegations, and any previous reports made to police or child protection authorities.

  3. Accused Person Profile: Fields to identify the alleged perpetrator, including their role within the church, contact information, and guardian details if they were a minor.

8U – Safe Church Concerns Form v1 06.02.25

8U – Safe Church Concerns Form v1 06.02.25

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