•	Call 999 to report emergencies or life threatening matters. 

•	Call 101 to report non-urgent crime incidents. 

•	Report new safeguarding concerns through your agency’s usual child safeguarding channels. If a safeguarding referral has been submitted there is no need to re-submit information via this form as this will lead to duplication of referrals.

•	If your information relates to a matter that has already been recorded by the Police and is not already known by the Officer in the Case (OIC), then please contact the OIC quoting the incident log or crime number. 

Please provide as much detail as possible. If you are not able to answer any of the questions please state ‘not known’ rather than guessing. The answers will help us determine how reliable, how accurate, and how old the information is.
If you are unsure as to whether you should submit this form please contact the Force Intelligence Bureau on 101 (West Midlands) ext. 822 5801 or email: fib@west-midlands.pnn.police.uk We are on duty Monday – Sunday 7am x 10pm.

1	1. Details of Professional submitting	
Name:	     	
Post/Job Title:	     	
Agency:	    	
Contact Details: Telephone:
Email:	     
     
     	

2. Information to be submitted	
Please provide clear and accurate information. Include as much detail as possible such as: 
WHO (names, dates of birth, descriptions, ethnicities, nicknames, phone numbers including both potential victim of trafficking and suspected offender).
     
     	
WHAT (account of incident)
     
     	
WHERE (locations, addresses, websites):
     
     	
WHEN (times, dates):
     
     	
HOW (recruitment method, where recruited, controlling behaviours, vehicle details, registration numbers):
     
     	
WHY (any identified vulnerabilities i.e. addictions, debt, health): 
     
     	
ANY OTHER INFORMATION? (For example, does your agency have any existing information that corroborates this new information being submitted)
     
     	

3	3. Date/time information received and how received	     

4. If the information was supplied by someone other than yourself, on a scale of 1-3 how reliable do you think they are? 	

	

5. How accurate do you think the information is on a scale of A-E?	

	

6. If the information is from a third party source, would they be willing to engage with the police?	

If Yes, please provide preferred contact details for the individual providing the information:

    

7. Does this information involve a licensed premise (e.g. newsagents, takeaways, pubs, off-licenses)? 	

If Yes, please provide the trading name and address of premise: