This form is for a Community Trigger referral only.
Thank you for completing this Community Trigger referral form.
If you have completed this form on behalf of someone else, please ensure that you provide us with their original written consent, quoting the reference number that you will be given when you submit this form.
If you have any queries regarding this form or the process you can either email firstname.lastname@example.org or write to:
Community Trigger referral
Public Protection Team, Community Safety
We are sorry but you are not able to continue with this application.
Please obtain written permission before you submit this form as you cannot apply for a Community Trigger on behalf of someone else without first obtaining written permission. This is because we will need to contact them and share their information.
Once you have obtained the victim's written permission please re-complete the form and send the consent to the Community Trigger Referral Team quoting the reference number generated either on the screen or the email confirmation sent to you after you have submitted the form. If you fear for your own or someone else’s safety, please call the Police on 999.