Incident Report

Name of person completing this form:*
First Last
Role of person completing this form:*
YOKE Folk, Team Leader, Staff, Etc.
Electronic Signature*
Signature
By selecting the "signature" button, you are signing this
incident report electronically. You agree your electronic signature is the legal equivalent of your
manual signature on this report and the report includes details of the incident to the best of your knowledge.
Date
Month
Day
Year
Incident Discription
Date of incident*
Month
Day
Year
Time of incident*

: Hours

Minutes

AM/PM
Name(s) of person(s) involved in the incident and their rol
YOKE Folk, YOKE Kid, Staff, etc.
Description of incident:
Witnesses (include contact details):
Incident Reported to:
YOKE Staff, School Staff, Etc.
First Last
Role:
YOKE Staff, School Staff, Etc.
Date
Month
Day
Year
How did you inform the above contact:
this form, in person, email, phone
Follow up action that were taken:

Incident Discription