Community Trigger referral form.
Your contact details
Please provide your details so that we can contact you. If you are completing this form on behalf of a friend or a client of your service, please provide details of the person affected by this situation. We will use this to ask any further questions or provide feedback on your referral as necessary.
Your details will not be shared with agencies outside of the Community Safety Partnership but will be stored in line with Data Protection principles.
Anonymous Community Trigger referrals will not be counted as community triggers but the details recorded will be shared with other agencies.
- select -
Please provide details of your landlord (2000 characters maximum):
Please provide details of your housing association (2000 characters maximum):
Please provide your other details (2000 characters maximum):
Equalities Monitoring (Optional questions)
Please give details of any disability (maximum 2000 characters):
White - English/Welsh/Scottish/N. Ireland/British
White - Irish
White - Gypsy or Irish Traveller
White – Eastern European
White - Any other background
Mixed/Multiple ethnic groups - White and Black Caribbean
Mixed/Multiple ethnic groups - White and Black African
Mixed/Multiple ethnic groups - White and Asian
Mixed/Multiple ethnic groups - Any other background
Asian / Asian British - Indian
Asian / Asian British - Pakistani
Asian / Asian British - Bangladeshi
Asian / Asian British - Chinese
Asian / Asian British - Any other background
Black / African / Caribbean / Black British - African
Black / African / Caribbean / Black British - Caribbean
Black / African / Caribbean / Black British - Any other background
Other ethnic group - Arab
Other ethnic group - Any other background
Prefer not to say
Details of incidents
The Community Trigger criteria is as follows: Three reports from an individual about separate incidents in 6 months or 3 individuals have separately reported similar in 6 months.
1) Please describe what has happened or is happening? (Maximum 2000 characters)
2) Who and how have you reported these problems to previously? (Maximum 2000 characters)
3) How have the incidents affected you? (Maximum 2000 characters)
4) What outcome would you like from the Community Trigger? (Maximum 2000 characters)
Keeping you informed
We will keep you informed about progress.
Our promise is to acknowledge receipt of your referral within two working days. An initial assessment of your situation will be carried
out at the next Anti-social Behaviour Agency Meeting (ASBAM). You will be notified of the outcome of the assessment within 5 working
days of the ASBAM meeting. If your referral meets the criteria an officer from an appropriate lead agency (in discussion with you)
will review your situation and advise of the next steps.
Please complete the validation below: