YEO Wellbeing Report - Rotary District 9660

Your Privacy and Data Security

This report contains sensitive information about a young person's wellbeing and is treated with strict confidentiality, consistent with Rotary's duty to keep young people safe.

Everything you enter is sent over a secure, encrypted connection (HTTPS).
The report is stored inside Rotary District 9660's private Microsoft 365 environment, where data is encrypted and access-controlled.
It is seen only by the authorised Youth Exchange officers responsible for the student's welfare.
The information is used solely to support the student's wellbeing and safety. It is not sold, published, or shared for any other purpose.
It is held and used in accordance with applicable privacy legislation and Rotary's privacy policy.

Questions about how this information is handled? Contact support@rotary9660.org.au.

1. Contact Details

Student Name

Country To/From

Host/Sponsor Club

Counsellor Name

Date of Contact

Type of Contact

2. Overall Wellbeing Snapshot

Rate 1 to 5 (1 = Concern, 5 = Excellent)

3. Discussion Summary

Short, factual summary of what was discussed

4. Key Areas Check

A. School and Routine

Attending regularly?

Yes No

Any concerns raised?

No Yes

B. Host Family Placement

Student feels safe and comfortable?

Yes No

Any tensions or concerns?

No Yes

C. Social and Cultural Adjustment

Making friends?

Yes No

Participating in activities?

Yes No

Cultural adaptation progressing?

Yes No

D. Program Compliance

Following Rotary rules?

Yes No

Travel permissions up to date?

Yes No

Any breaches?

No Yes

Engaging with Hosting Rotary Club?

Yes No

5. Student Voice

Important: capture their words where possible

What is going well

What is challenging

Any requests or concerns

6. Safeguarding and Risk Check

Any signs of:

Isolation Bullying Mental health concerns Host family issues Inappropriate behaviour toward student

7. Actions and Follow-Up

Actions required?

No Yes

8. Escalation

Not required Yes, required

9. Next Contact

Scheduled date

Method

10. Report Completed By

Name

Role

Date

Signature

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