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Concern Card
Concern Card
Name
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Year Group
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Tutor Group
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Who are you concerned about?
E.g. Me, a friend, family
*
Type Of Concern
Bullying (Select from the following)
Physical bullying (e.g. kicking, hitting, pushing)
Verbal bullying (e.g. name calling, teasing, insulting)
Psychological bullying (e.g. spreading rumours, being isolated, hurtful jokes)
Cyber bullying (e.g. unpleasant messages, photos being sent/posted)
Targeted bullying (e.g. references to being gay or disabled, racist or sexist remarks)
Sexting
Sexting
Online Activity
Online Activity
Drugs, Smoking, Alcohol
Drugs, Smoking, Alcohol
Mental Health and Emotional Wellbeing
Mental Health and Emotional Wellbeing
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Relationships, sexuality and sexual health
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Friendships
Is this concern while you are:
In School
At Home
Out In The Community
Further Information
Please describe your concerns.
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Concern Card
