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Custody Intake and Welfare Assessment Form

FormControlled document
NPS-FRM-001
v3.0
Document ownerSergeant, Custody and Protective Services
Version3.0
Approved8 January 2026
Next review8 January 2027
StatusCurrent

Purpose. This form records the reception and risk assessment of every person taken into custody and sets the welfare check interval.

1.When to use this form

The custody officer must complete this form for every person received into custody, before the person is placed in a cell. The form must be completed with the person where their condition allows. A copy must be attached to the Custody Register entry.

2.Completing the assessment

Ask every question and record the answer even where the answer is no. Observe the person as well as asking, and record what you see. Where any risk indicator is present, set the welfare check interval to fifteen minutes and notify the sergeant.

  • Ask, observe and record
  • Never leave a question blank
  • Escalate any risk indicator

3.Notifications

Where the person is an Aboriginal or Torres Strait Islander person, notify the Aboriginal legal service and record the time. Where the person is under eighteen, notify a parent, guardian or independent person and record the time. Where the person requests a lawyer, record the request and the time the call was made.

4.Medical referral

Where the person reports or shows an injury, illness, medication need or mental health concern, call a medical practitioner or an ambulance and record the time and outcome. Do not place a person who is unconscious, has a head injury or is severely intoxicated in a cell.

5.Sign off

The custody officer and the sergeant must both sign the form. The form must be reviewed at every shift handover while the person remains in custody, and any change in condition must be recorded as a new assessment.

6.Complete the form

NPS-FRM-001 v3.0 · CAQA Northgate Police ServiceUncontrolled when printed. Simulated document created by CAQA for training and assessment.