Incident Report - Messiah University

1. Report Created By (first and last name) Required

2. Messiah Email Required

3. Persons Involved (in order from most involved to peripherally involved) Required

4. IDs Viewed (to confirm identity) Required

5. Incident Date Required

6. Incident Time (am/pm) Required

Help: Please specify am or pm

7. Location of Incident Required

8. Other Location (if “other” above)

9. Additional Location Details (apt/room/house number, building (if not specified above), which lounge, etc.) Required

10. Report Summary (detailing the incident, who was involved/called, and what steps were taken) Required

11. Incident Type (select all that apply) Required

12. Attachments

Help: Uploading pictures, emails

13. RDs Involved (RD of building where incident occurred, RD On Call (if involved), and/or RD of students involved - if known) Required