This Incident Report is completed by (include your full name and contact details including email & phone number): 

Describe the incident that occurred (remember to describe the facts of the incidents not your opinions)

Record the location the incident occurred, as well as the date & time.

Persons affected by the incident 

Cause of the incident 

Record any injuries including the person injured, how/where they were injured. Include the contact details including name phone number and email of the person injured. 

If injured, what medical aid was provide? And by who?

Name & contact details of any witness (including phone number & email address)

Would you consider this a serious incident 

Was any additional investigation carried out and/or was the incident reported to any body or agency (e.g NDIS, Centre service being held in , Real Estate)

Have any steps been taken or suggestions made to reduce or avoid the same indictment from occurring again