Incident Report Form
If there is an accident or injury, please use this form to report what happened.
Name of person(s) involved or injured:
Location of Incident:
Reported or Witnessed By:
First Name
Last Name
What Occurred?
Was the person involved taken to the hospital?
Yes
No
Steps taken after the incident:
Attach photos, statements, or other information if available.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
We appreciate your feedback!
Submit
Should be Empty: