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School Incident Report Form

This incident report form is used to document any accidents, injuries, thefts, violations, incidents, illnesses, or other events that occur at school. It collects information about the type of incident, those involved, location, time, witnesses, a description of events, any actions already taken, and suggestions or recommendations from the completing teacher. The completed form should then be submitted to the school principal or administrator.

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BenjaminJrMoronia
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2K views1 page

School Incident Report Form

This incident report form is used to document any accidents, injuries, thefts, violations, incidents, illnesses, or other events that occur at school. It collects information about the type of incident, those involved, location, time, witnesses, a description of events, any actions already taken, and suggestions or recommendations from the completing teacher. The completed form should then be submitted to the school principal or administrator.

Uploaded by

BenjaminJrMoronia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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INCIDENT REPORT FORM

Use this form to report any accident, injury, theft, violations, incident, illness, others
Submit completed form to the School Principal/Administrator.

This is documenting a/an:

Violation Accident Incident Illness Observation Others

Teacher Completing Report:__________________________________ Date:__________


Student(s)/Person(s) Involved:________________________________________________
Grade Level:______________
Date of Event:______________ Location of Event:________________________________

Time of Event:_____________ Witnesses:______________________________________

Description of Events (Describe sequence of events):


________________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
*If more space is required, please use the back of this sheet

Action Already Taken (if any):


_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

Suggestion/Recommendation/Remarks:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

Signature of Teacher:_____________________________ Date:__________________

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