Tell us about a rough sleeper


If you see and are concerned about someone who is rough sleeping, please tell us. Please help us by providing as much information as possible.

Email us if you wish to discuss a rough sleeper – office@canaan-trust.co.uk

REPORT ON A ROUGH SLEEPER
Description of rough sleeper and their location

    Name (if known):
    Age (approx)
    Ethnicity
    Gender MaleFemaleUnknown
    Hair Colour
    Approximate height
    Other identifying features (colour of clothing etc)
    Location/area
    Length of time at location (if known)
    What time(s) are they usually there?
    Additional information
    Please give details if they are exhibiting any concerning behaviour (threatening verbal/physical behaviour)
    Are you aware of any contact which may have been made with Local Council
    Please provide any information which would enable staff to contact the individual safely.
    Is the individual concerned aware of this referral YesNoDont know
    Are you aware of any specific support needs? Drug/substance usePersonal CareElderlyChronic illnessAlcohol usePhysical disabilityYoung
    Please provide your own contact details (optional)
    Name
    Contact number
    Email address
    We will not retain your information for any purpose other than confirming referral and to seek further information if deemed helpful.
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