The Highland Council 
Whistle Blowing Form
Strictly Confidential	
Use the tab key in order to move between fields. The form may then be saved and printed or emailed.	

Name	           	Date of Complaint:	     	
Do you wish your name to remain confidential as far as possible?              	
YES/NO	
		
Initial Contact Details			
1.	Please contact me at home in writing only.  	
Home Address	     

          
	
OR		
2.	Please contact me by telephone only.  The usual hours when I can be contacted on this number are:	
Telephone Number:	     	
Hours Available:	     	
		
Details of Concern:

Put in here a summary of your concern.  You should say what your concern is; whom is involved; why you are concerned; when did the concern arise; if there are other people who can verify your concern.  Continue on a separate page if you wish. 
	
          

	
Signature: ……………………………………………………………..	               (Date)	

You send this form to your Director, unless s/he is the subject of complaint, when it should be passed to the Chief Executive.  For Chief Executive's staff, it should be given to the Chief Executive, whom failing, the Head of People and ICT or Director of Corporate Resources.

You will be contacted by a senior member of staff, who will confirm the process to be followed and agree how you are to be contacted in future.  Whilst we shall try to keep your name as confidential as possible, please be aware that it may well be necessary to reveal it as part of the investigatory process.
	
Signature of Recipient of Concern: ……………………………………..                                              	               (Date)	
Summary of Immediate Action Taken By Recipient: