InCIDENT REPORT

Complete any incident or accident reports and submit them to a YMI staff member in a timely manner

Please note: Drafting an incident report as soon as possible after an incident is crucial to maintaining an accurate record of events. It is important to capture as much detail as possible while the events are still fresh in one's memory. Incident reports serve as legal documentation of events that could potentially lead to lawsuits, so it is critical to be as accurate and thorough as possible.

Date of Incident

[Insert date and exact time]

YYYY

Time of Incident

Hour

Minute

Second

Location of the Incident

[Be specific—include site name, room, trail marker, etc.]

Description of the Incident

[Describe what happened in detail. Include any injuries, damage, or escalation. Note weather conditions or contributing factors if relevant.]

Names and Contact Information of Witnesses:

First Name

Last Name

Phone

(###)

###

####

Name

First Name

Last Name

Phone

(###)

###

####

Immediate Actions Taken:

[First aid administered? Emergency services contacted? Youth removed from situation? Who responded and how?]

Name and Contact of Person Filing Report:

First Name

Last Name

Phone

(###)

###

####

Confidential Information (if applicable)

[Note any sensitive or personal information shared by youth or their families. Use initials instead of full names when possible.]

NOTES:

- Please maintain a copy of this report for your personal records.  - Reports should be emailed to YMI staff immediately. If no internet access is available, handwrite and email a digital version as soon as possible.  - Maintain confidentiality and follow all YMI safety and reporting protocols.

InCIDENT REPORT

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