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The document is a sample incident report form for teachers in a school, designed to capture details of incidents that occur. It includes sections for the date, time, location, individuals involved, witnesses, actions taken, and follow-up actions required. The form also requires signatures from the reporting teacher and an administrator.

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0% found this document useful (0 votes)

7 views2 pages

Sample Teache2

Uploaded by

justinenamalawa48

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as DOCX, PDF, TXT or read online on Scribd

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sample teacher's incident report form in a school

Here's a sample incident report form for teachers in a school setting:

---

School Incident Report Form

Date of Incident: ________

Time of Incident: ________

Location of Incident: ________

Reporting Teacher's Name: ________

*Grade/Class:* ________

*Incident Description:*

(Provide a detailed account of the incident, including what happened, who was involved, and any
relevant context.)

__________________________

__________________________
*Individuals Involved:*

1. Name: ___ Role: _ Contact: ___

2. Name: ___ Role: _ Contact: ___

3. Name: ___ Role: _ Contact: ___

*Witnesses:*

1. Name: _ Contact:

2. Name: _ Contact:

*Action Taken:*

(Describe any immediate actions taken in response to the incident, such as contacting parents,
administering first aid, etc.)

__________________________

Follow-Up Actions Required:

(Outline any further steps that need to be taken, including notifying administration or other relevant
parties.)

__________________________

Signature of Reporting Teacher: _ Date:

Signature of Administrator: _ Date:

Feel free to modify this template to fit the specific needs and policies of your school.

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Sample Teache2

Uploaded by

Sample Teache2

Uploaded by

sample teacher's incident report form in a school

Here's a sample incident report form for teachers in a school setting:

School Incident Report Form

Date of Incident: ________

Time of Incident: ________

Location of Incident: ________

Reporting Teacher's Name: ________

1. Name: ___ Role: _ Contact: ___

2. Name: ___ Role: _ Contact: ___

3. Name: ___ Role: _ Contact: ___

1. Name: _ Contact:

2. Name: _ Contact:

Follow-Up Actions Required:

Signature of Reporting Teacher: _ Date:

Signature of Administrator: _ Date:

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Sample Teache2

Uploaded by

Sample Teache2

Uploaded by

sample teacher's incident report form in a school

Here's a sample incident report form for teachers in a school setting:

*School Incident Report Form*

*Date of Incident:* ________

*Time of Incident:* ________

*Location of Incident:* ________

*Reporting Teacher's Name:* ________

1. Name: _______ Role: _______ Contact: _____

2. Name: _______ Role: _______ Contact: _____

3. Name: _______ Role: _______ Contact: _____

1. Name: _______ Contact: ______

2. Name: _______ Contact: ______

*Follow-Up Actions Required:*

*Signature of Reporting Teacher:* _______ *Date:* ______

*Signature of Administrator:* _______ *Date:* ______

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Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

School Incident Report Form

Date of Incident: ________

Time of Incident: ________

Location of Incident: ________

Reporting Teacher's Name: ________

1. Name: ___ Role: _ Contact: ___

2. Name: ___ Role: _ Contact: ___

3. Name: ___ Role: _ Contact: ___

1. Name: _ Contact:

2. Name: _ Contact:

Follow-Up Actions Required:

Signature of Reporting Teacher: _ Date:

Signature of Administrator: _ Date: