[School Name/Logo]
School Incident Report
Student/Staff Involved
Name: ____________________________________
Grade/Position: ___________________________
Class/Department: _________________________
Date of Incident: _________________________
Time of Incident: _________________________
Location: ___________________________________
Description of Incident:
This section should provide a detailed account of the incident, including the behavior or actions that led to the incident, any conflicts that occurred, and how the situation was handled at the moment. It should be as descriptive as possible, capturing all relevant details.
Injuries or Damages:
Document any physical injuries or property damage resulting from the incident. This may include descriptions of how the injuries occurred or what items were damaged.
Witnesses:
Include the names of students, staff, or other individuals who witnessed the incident. Their contact information should also be recorded for follow-up if necessary.
Immediate Actions Taken:
Describe the actions taken immediately following the incident, such as notifying parents, administering first aid, or involving school security or authorities.
Follow-Up Actions:
This section should outline the steps that will be taken to address the incident and prevent recurrence. It may involve counseling, disciplinary action, or changes to school policies or procedures.
School Incident Summary Table:
| Detail | Description |
|---|---|
| Date of Incident | [Enter Date] |
| Location | [Enter Location] |
| Injuries or Damages | [Describe Injuries/Damages] |
| Witnesses | [List Witnesses] |
| Immediate Actions | [Describe Immediate Actions] |
| Follow-Up Actions | [Describe Follow-Up Actions] |
Reported By:
Name: ____________________________________
Position: _______________________________
Signature: _______________________________
Date: ___________________________________