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Incident Report
Incident Report
Staff name
*
Answer Required
Staff email
*
Answer Required
Staff phone number
*
Number Required
Date of incident
*
Answer Required
Time of incident
*
Answer Required
Exact location of incident
*
Answer Required
Describe incident that occurred in sequential order, including who was involved and the outcome.
Answer Required
Type of incident
*
Answer Required
Accident
Assault / Battery
Building Damage
Burglary
Computer Crime
Contraband
Drugs / Alcohol
Fraternization
Fire / Fire Alarm
Fight
Graffiti
Harassment
Medical / Illness
Psychological
Slip / Fall
Threats
Theft
Trespass
Vandalism
Vehicle Accident
Other:
Who has been notified and how were they notified?
Answer Required
Police
Fire Department
Parent / Guardian
Who was involved?
Person 1 name
Answer Required
Person 1 contact
Answer Required
Person 2 name
Answer Required
Person 2 contact
Answer Required
Person 3 name
Answer Required
Person 3 contact
Answer Required
Person 4 Name
Answer Required
Person 4 contact
Answer Required
Describe the incident
*
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Please upload relevant files.
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Choose a file
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