Kids Hope Incident Report Form
We take incidents very seriously. Please be as detailed as possible in filling out this form.
Date of Incident
*
Time
*
Name of child involved in incident:
*
Name of child's mentor:
*
Location where incident occurred:
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Details of incident:
*
Did this incident include an injury
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Please select one option.
Yes
No
Detail of injury, if any:
*
Action taken as a result of an incident
*
Name of person submitting report
*
Unnamed Label
*
Submit
Description
We take incidents very seriously. Please be as detailed as possible in filling out this form.
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