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Prevent referral form By sending this form you consent for it to arrive with both your dedicated Local Authority safeguarding team and Prevent policing team for a joint assessment. Wherever possible
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How to fill out prevent referral form

01
Obtain a copy of the prevent referral form from the appropriate agency or department.
02
Fill out the personal information section with your full name, address, phone number, and date of birth.
03
Provide specific details about the individual you are referring, including their name, age, address, and any relevant background information.
04
Describe the reasons for your referral, including any concerning behaviors or indicators of radicalization.
05
Include any relevant contact information for the individual or their family members, if available.
06
Sign and date the form to certify the accuracy of the information provided.
07
Submit the completed prevent referral form to the appropriate agency or department as instructed.

Who needs prevent referral form?

01
The prevent referral form is typically needed by individuals or organizations who have concerns about someone they believe may be at risk of radicalization or involvement in extremist activities.
02
This could include teachers, social workers, healthcare professionals, community members, or law enforcement personnel who come into contact with vulnerable individuals.

What is Prevent Referral - Home (walsall.gov.uk) Form?

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Instructions for the form Prevent Referral - Home (walsall.gov.uk)

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Prevent referral form is a document used to report potential cases of preventable incidents or issues.
Anyone who becomes aware of a potential preventable incident or issue is required to file a prevent referral form.
To fill out a prevent referral form, individuals should provide detailed information about the incident or issue, including time, date, location, and any individuals involved.
The purpose of prevent referral form is to address and prevent future incidents or issues that could have been avoided.
Information such as incident details, individuals involved, witnesses, and any relevant evidence must be reported on prevent referral form.
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