FBC Incident Report
Staff Name
*
First Name
Last Name
Date of Incident
*
-
Month
-
Day
Year
Date
Time of Incident
*
Hour Minutes
AM
PM
AM/PM Option
Member Name
*
First Name
Last Name
Member Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Member # (Global Membership ID on res site under their profile, starts with M-)
Marina Location
*
Please Select
DS43-Julington Creek East
DS230-Jacksonville Beach
DS1169-Julington Creek West
DS89-St. Augustine Camachee
DS1073-St. Augustine Shipyard
Member Email
*
example@example.com
Reciprocal?
*
Please Select
Yes
No
Boat Name
*
Reciprocal?
Yes
No
Boat
*
Please Select
(904) Happy Hour V
Add to Cart VII
Ahoy Matey IV
All Good Days
Alotaluck III
Always Sunny III
Anchor Management VI
Aquatainment
At Ease
Aweigh We Go IV
Baby Hewey VII
Beginners Luck VII
Boativation
Bob II
Bonus Hours
Bonus Time
Branch Office IV
Breezy Does It
Buddy Boys Toy IV
Cami Sue II
Capital Sea IV
Captain's Choice IV
Carry On II
Comfort Zone
Conference Room III
Cool Breeze
Creek Life
Dances With Waves V
Dreams Come True V
Easy Livin V
Efishient VI
Excused Absence
Executive Suite IV
Family Function II
Fantastic Voyage
Favorite Child II
Feelin Nauti VI
Field Trip IV
Fishful Thinking IX
Fish Tank VIII
Fishy Business VII
Florida Room VI
Flounderin Around IV
Flounder Pounder VII
Forget Me Knot IV
Fortunate Cookie V
Get Ready V
Getting Reel V
Good Excuse
Group Therapy III
Gym Dues III
Happiness Project
Hoa Violation
Hooked Up IV
In a Meeting II
In Time Out
Jordan Lori
Just Add Water VI
Just Playin IV
Kismet II
Knot Bad IV
Knot Boring
Knot On Call IV
Knot On The Clock
Knot Working IV
Lando's Wave II
Land Phobic II
Liquid Asset V
Lucky Enough II
Mandatory Overtime
Marine 4 IV
Memory Maker IV
No schedule III
Off Duty V
Office Hours IV
Off The Hook VII
One More Toy IV
Out Of Office III
Pa's Time III
Perfect Partnership III
Perfect Remedy lll
Pier Pressure III
Playin Hooky VII
Playtime IV
Premium Reel Estate VI
Price Was Right IV
Prime Time II
Reel Busy IV
Reel Clear III
Reel Deal V
Reel Escape V
Reel Happy IV
Reel Lady III
Reel Life III
Reel Memories V
Reel Merchant VI
Reel Obsession IV
Reel Satisfaction IV
Reel Seacrets III
Reel Serenity IV
Reel Teal II
Reel Therapy VII
Reely Living V
River Effect III
Salty Soul III
Scenic Route IV
Sea Batical
Seabreeze III
Sea Chaser II
Sea Esta III
Seafari III
Seas Cool III
Sea Senora III
Serenity Now
She Shed II
Shore Beats Working V
Showtime IV
Ski Ya Later VII
Social Distance III
Splash Pad IV
Stress Relief III
Take it Easy
The Boardroom IV
The Good Life
The Great Gatsea
The Office VII
Tide Life
Today's Toy
Truly Blessed III
Utopia III
Vitamin D FL3386TZ
Vitamin Sea VII
Waterfront Property II
Wave Rider III
Waves Goodbye VII
What's My Line V
How many guests on board? Any notes on guests?
Location of Incident
*
Please Select
Navigating Inside Marina
Navigating Outside Marina
While Docking
Walking the dock
Parking Lot
Office
Other
Description of Incident (Provide a clear summary of the incident)
*
How did you hear of incident?
*
Witnessed firsthand
Member
Post-trip inspection
Reported by marina
Reported by guest of member
Reported by dock staff
Law Enforcement/FWC
Other
Responsible Party
*
Member
Club
To be determined
Other
Incident Type
*
Lost gear (anchor, prop, etc)
Return Time
Incorrect fuel charge
Member beached/grounded/tide related
Contact with another boat/dock
Boat/Engine Issue
Injury/Medical Event
Member/Guest Behavioral
Law Enforcement/FWC
Line in prop
Other
Was emergency assistance called?
Yes
No
Description of injury
Remedy (Choose all that apply)
*
Management to call member
Addressed member on dock
Replace Item (Anchor, Prop, Battery, etc)
Jump battery
Called tow
Canceled tow
Member waited for tide
Repaired issue
Switched boats
Member returned early
No pay on fuel
Other
Item Replacement
Prop
Entire Anchor Kit
Anchor Only
Battery
Other
Did you create a Fleetio issue? (Only needed for issues left unaddressed after IR)
*
Yes
No, not needed
Test drive?
*
Yes, boat ran normal
Yes, boat ran rough
No, boat is completely out of service
No test drive needed
No time to do so
Photos (Damage, Video, etc)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Suggest retraining?
*
Yes
No
Optional notes
David
example@example.com
Mackenzie
example@example.com
Submit
Should be Empty: