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Section 1 – Candidate employment details
From [DD/MM/YYYY]
to [DD/MM/YYYY]
Section 2 – Safeguarding information

The information in this section should provide facts (not opinions) of any substantiated safeguarding concerns/allegations that meet the harm threshold. They should not include information about concerns/allegations that are unsubstantiated, unfounded, false or malicious.

Please confirm the candidate’s reason for leaving your employment

The harm test is explained in the Disclosure and Barring service Guidance: Making barring referrals to the DBS and Section 35(4) of the Safeguarding Vulnerable Groups Act 2006.

Would you re-employ the candidate at your organisation?
Are you aware of any allegations or concerns that have been raised (whether formal or informal) about the candidate that relate to any safeguarding issues?
Are you aware of any safeguarding conduct or concerns regarding the candidate that have led to any referrals to the Disclosure and Barring Service (DBS)?
Section 3 – Referee details and signature
Reference completed by
Clear Signature
By signing on this page, I confirm the information provided is a true and honest representation of the candidate named above.
[DD/MM/YYYY]