FTCO Statistical Record Form

FTCOs are asked to complete this form for all contacts where they are asked to provide support.

Where you do not know or are unsure of the relevant answer please select Unsure or Other.

FTCO statistical record form

FTCO details

Name

ID

Email address

How did the contact find out about the FTCO Network

Contact found network through

Other

The contact is

Other

Complainant's statistics

There are multiple complainants

Gender of complainant

Complainant's position at the University

Other

Complainant's Faculty/Division

Other

Total time with complainant

Date of contact

Respondent's statistics

Gender of respondent

Respondent's position at the University

Other

Respondent's Faculty/Division

Other

The issue

Occurrences

The pattern of behaviour is best described as

The first issue occurred

Description

Add behaviours

Re-order	The behaviour is best described as	If 'other'	Weight	Operations
	The behaviour is best described as	If 'other'	Item weight

more items

The issue occured because of

Other

The response - agreed action

The contact has been sent details of the EAP

Referral

Other