Critical Incident Report Form

2. Actions Taken:
Details of Immediate actions taken when Critical Incident occurred:
Were these actions effective in dealing with the Critical Incident? *
Are there any preventative measures that can put in place to prevent another similar Critical Incident occurring: *
Please specify the details: *
Have all staff/students affected been offered de briefing/ counseling sessions? *
Were these effective? *

3. Follow Up:
Are there any changes/ improvements required for our Critical Incident Policy? *
Please specify the details: *
Do any staff require any professional development to improve their skills following this critical incident?
Reporting Officer Name: *
Reporting Officer Signature *
Date *

Day Month Year
Pramukh Group of Companies T/A Harward International College

ABN: 72 135 865 066 I ACN: 135 865 066

Phone: 03 9639 4699 I Fax: 03 8669 4055

Email: info@harward.vic.edu.au I Web: www.harward.vic.edu.au
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CRITICAL INCIDENT REPORT FORM