Incident Report Form

At Vibrant Community Health, we are dedicated to ensuring the safety and well-being of our clients, staff, students, volunteers, and visitors. It is crucial to report all incidents, no matter how minor they may appear. By documenting each incident, we can build a comprehensive profile of potential risks affecting our community.

Reviewing the patterns and trends of these incidents helps us identify underlying risks and implement corrective measures to prevent future occurrences. Your detailed and accurate reporting is essential in maintaining a safe environment for everyone involved.

Site Location

Date & Time of Incident

People Involved

(include name and position for the staff involved)

Description of Incident & any Immediate Actions taken

(brief and actual account of what happened, also list if there were any injuries)

Report completed by

Mention Name, Position, & Date