Incident report
This is intended to be an objective report of what was observed - a description of the incident, who was involved, and the resolution. Please do not draw conclusions about wellness/intent.
Briefly describe the incident *
Your answer
Filed by *
Your answer
Your email address *
Your answer
Date and time *
MM
/
DD
/
YYYY
Time
:
Location *
If other, where?
Your answer
Police department called *
User asked to leave library *
Incident type *
Name of user causing incident (if known)
Your answer
User affiliation *
Probable age range *
Gender *
Required
Approximate height
Build type (check those that apply)
Ethnicity/race
Complexion type
Hair color/style
Your answer
Eye color
Other descriptive information (eg: tattoos, facial hair, clothing, footwear, etc.)
Your answer
Previous incidents with user? *
If yes, describe:
Your answer
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