Incident flash report checklist

Template Questions

• Description of the Incident:
• Location:
• Name/s of persons involved:
• Staff dealing with incident:
• Staff attending incident site:
• Responsible Supervisor/Manager:
• Provide details of any corrective action taken at the time of this report:
• Incident Type
• Other description
• Drug and Alcohol Testing
• Incident Classification
• Name
• Signature
• Phone number