Incident Report New

Please ensure this document is completed within 24 hours of an incident. If emergency services are required, and you are able, please let the relevant Liaison know and give an estimate of when you will be able to complete this.

Name of staff completing this document

Date of incident

Date

Time of incident

Location of incident

Who is your Support Officer (So this can be sent to them)

Details and Type of incident

If other please give details

Who was involved, If external please put contact details below

Description of incident. Please use objective information only

Immediate actions following the incident If the police were called please include the report number

Description Reportable incident, please include if this was an authorized Restrictive practice or unauthorized, describe the scenario, the restrictive practice and why it was used:

File Upload - if supporting files/photos available