YFX INTERNAL STAFF Incident report

Incident reports are necessary for documenting details of the occurrences while they are most present in the minds of the witnesses and incident reporter. The information that is included in the report can be useful for decision-making on future incidents, identify behavioral patterns and identifying larger issues. To maintain a safe and healthy work/community environment, a thorough investigation should be undertaken following an incident in order to initiate corrective actions.

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REPORTER DETAILS

Name

First Name

Last Name

Title/Role/Position

Date of Report

YYYY

EMPLOYEE DETAILS

Please input the information of the staff member you're submitting this incident report on.

Name of Staff

First Name

Last Name

Title/Role/Position

Phone

(###)

###

####

Name/Role/Contact of Parties Involved

Please list the name, role, and contact info of any additional parties involved in the incident you are reporting on. If there are no additional parties involved, please input "N/A"

Name/Role/Contact of Witnesses

Please list the name, role, and contact info of any witnesses that may have been present during the time of the incident you are reporting on. If there were no witnesses, please input "N/A"

DESCRIPTION OF INCIDENT

To the best of your ability, please outline below the details that took place in the incident you are reporting on.

Incident Details

How the incident happened, factors leading to the event, and what took place. Be as specific as possible

Date of Incident

YYYY

Time of Incident

Hour

Minute

Second

Estimated Time

If the exact time of the incident is uncertain, please provide an estimated tine of day.

Location of Incident

Please describe the location of the incident and/or provide an ADDRESS where the incident took place (City/State/Zip Code/Country)

Specific Area of Location

If applicable, please provide the specific area in which the incident took place at the location identified above

Offense/Incident Description

Please include any events leading up to or immediately following the incident you are reporting on

Incident Causes

Please include any additional information on what may have caused the incident to take place

Follow-Up Action

Please share any resulting action executed, planned, or recommended.

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YFX Internal Staff Incident Report

YFX INTERNAL STAFF Incident report

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Youth FX