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Incident Report Form

For Staff and Student Use

Incident Report (IR) Download Instructions:
  1. Right click on the Incident Report.doc Download below and select Save Target As ...
  2. Choose where on your computer you would like the item saved to.
  3. Select Save
  4. Fill out the form and email as per the instructions below.
  5. We encourage you to ask your RA or RLC to assist you. They regularly write Incident Reports and can offer much experience.

  • Incident Report


  • Follow the instructions to save the blank document to your desktop. This will be your starting point when you need to write an IR. Read over the IR and become familiar with the form.

    WRITING AN IR

    First, ensure you are in a private location where others will not be able to read what you are writing. This is a confidential document and should not be seen be anyone but the author and the recipients.

    To write an IR, log onto a computer using your UANet ID (such as your personal PC or your RLC's computer). This computer should have the blank IR installed. Open the blank IR form. Use your name and the date as the file name.


    Helpful Hints:

    • Complete all the white spaces on the IR. The gray spaces are to be completed by your RLC after you submit the form.

    • Click to the left-most section of a box to enter the cursor in that space or simply TAB to each box.

    • In the "WITNESS" section, choose Y for "YES" (was a witness to the incident) or N for "NO" (was not a witness ~ rather was involved in the incident).

    • In the "DATE OF INCIDENT" section, enter the date and choose either AM or PM.

    • In the "REPORTED TO" section, choose the RLC from the hall in which the incident took place (most often your own RLC).

    • When writing the text, remember ...


      • Always include as much detail that is pertinent and useful;

      • IRs are to only contain factual information - no impressions or conjecture should be included in the text of the email when you submit the IR. Include sights, smells, sounds, etc., not feelings or impressions.

      • Check your facts.

    • The last steps to writing an IR are to re-read it, proof your information and make sure you have included all the data needed.


    SUBMITTING AN IR

    When you have completely finished writing your IR:

    Please recognize how important it is that these documents are well-written and confidential. Once again, do not under any circumstances leave this finished document on the computer once it has been sent via email. It must be placed in the Recyle Bin and emptied. If you need to review your IR Report, see your RLC who will have a saved copy for you to view.
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    Last modified: August 13 2007 12:02:13