Opening Up Checks (Nightly)

1

Email

example@example.com

2

Who is completing this form ?* This field is required.

3

Who is Duty Supervisor tonight* This field is required.

5

What was the date and time of the incident* This field is required.if this form is

Date

Hour

Minutes

7

What type of incident was it ?* This field is required.

8

Where did the incident take place.* This field is required.If it happened in multiple areas please specify

9

Describe the incident, please include names of anyone involved (if known)* This field is required.

10

Are there any witnesses to the incident ?* This field is required.

YESNO

11

Who witnessed it ?* This field is required.

12

In your opinion was a crime committed ?for example, if you are reporting sexual assault then the answer would be yes

YESNO

13

Were the Police called ?* This field is required.

YESNO

14

What did the Police do ?* This field is required.

15

Why wasn't the Police called ?* This field is required.If the victim does not want to persue the matter please remind them that if they change their mind then we only retain CCTV for 31 days.

16

Do you want the performer to sign this ?* This field is required.

YESNO

17

Performer signature* This field is required.

18

Name of the performer that just signed * This field is required.

19

Signature of person completing this form