Duty to Report Form

The Duty to Report Form  is a formal document for use by professionals ordinarily; however anybody can make a referral. A "report" is the direct reporting of an allegation, concern or disclosure to a statutory organisation such as Social Services, Police or Health. It is a concern that is formally recorded on a Form, and is the start of the formal adult protection process.

The duty to report form must be sent to Social Services, Health or the Police as soon as possible and in any case within one working day of being alerted to the abusive situation.

If you are a member of the public, please note that its is not necessary to complete the form. Concerns can be reported in person, by telephone, in writing, by secure fax or by e-mail


As a professional it is expected that the duty to report form is completed in as much detail as possible. Please note that the attached form is a Gwent area form and amendments to this form may have been made locally. Please be mindful of any local arrangements your local authority has for reporting concerns and making referrals.


Duty to report form


Duty to report form associated guidance

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