Child Safety Reporting Form

You can download the fillable form on this page, or complete the online form below. 

Download the PDF form 

Child Safety Reporting Form Fillable

164.9 KB

You can return this form to Meander Valley Council by:

  • Emailing it to childsafety@mvc.tas.gov.au
  • Dropping it off at 26 Lyall St, Westbury Tasmania 7303
  • Mailing it to PO Box 102, Westbury Tasmania 7303

 

Online Child Safety Reporting form

1. Your details

Can we contact you for further information, if required?
How Can We Contact You?
What best describes you? 

2. Details of involved children

Please fill out the name, age, date of birth and any other information for each child involved.

3. Details of involved Council Workers

Please fill out the name, role information and any other identifying information of each council worker involved.

4. Conduct by Council Worker

Please include as much detail as you can.

5. Who else has been notified?

Notified Persons

6. Further information

Personal Information Collection Notice

You are providing personal information to Council, which will be managed in accordance with the Personal Information Protection Act 2004. This information will be used for:

  • reporting, investigating, and responding to your concerns
  • following up with you, where appropriate
  • meeting legal obligations, including disclosure to
    • the Office of the Independent Regulator
    • Tasmania Police or other relevant law enforcement bodies
    • other entities permitted under the Child and Youth Safe Organisations Act 2023
  • related purposes or lawful disclosure to third parties

Please note

  • failure to provide this information may limit Council’s ability to address your concerns or maintain proper records
  • you have the right to request access to your personal information held by Council
I Understand the Personal Information Collection Notice