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Non-Staff Incident Report

  1. Incident Report (Internal Non-Staff)

  2. Incident Details

  3. Incident Type*

  4. Did Staff Member Witness the Incident?*

  5. Please be specific but only report facts.

  6. Patron Information

  7. Gender

  8. Police/EMS

  9. Was a police report written?*

  10. Was EMS involved?*

  11. Did patron accept/decline transportation to a medical facility?*

  12. If declined, did the patron return to activity?

  13. Incident Documentation

  14. Leave This Blank: