Incident Report
School District of Manawa
Instructions
Complete this report under any of the following situations:
A. A child becomes ill or receives an injury that requires First Aid or medical treatment while in your care;
B. A child receives a bump or blow to the head or other visible injury regardless of treatment;
C. A child is transported by ambulance from your facility;
D. An unusual or unexpected incident occurs that jeopardizes the safety of a child, such as a child left unattended there is a vehicle accident (with or without injuries), or a child is exposed to a threatening person or situation;
E. There is an allegation or reasonable suspicion of abuse of a child.
Complete this report in its entirety.
Use fact-based statements only. Submit this form no later than 24 hours after the incident.
Next
Never submit passwords through Google Forms.
This form was created inside of School District of Manawa. Report Abuse - Terms of Service - Additional Terms