Incident Report Use the form below to report an incident to the Board of Directors. Reports will be handled as privately as possible and shared only with those responsible for review and follow-up. You may submit anonymously, but including your contact information may help us follow up if more information is needed. Please include only what you know or observed and avoid speculation.Your NameYou may leave this blank if you wish to remain anonymous. First Last Email PhoneLocation of IncidentExample: theatre, lobby, backstage, classroom, rehearsal room, offsite event, etc.Person(s) Directly InvolvedPlease include names if known/applicable.Were minors involved or present? Yes No Unsure WitnessesPlease include names/contact information if known.Who was contacted at the time? Executive Director Board President Board Vice President DSL Staff / Leadership Immediate Action TakenPlease include any steps taken in the moment, such as contacting staff/board, replacing a volunteer, contacting a parent/guardian, pausing activity, calling emergency services, etc.Brief Factual Summary of What HappenedPlease include what happened, who was involved, where it happened, and any immediate safety concerns. Please avoid speculation and include only what you know or observed.Date of Incident MM slash DD slash YYYY Approximate Time of Incident Hours : Minutes AM PM AM/PM Is follow-up needed? Yes No Unsure Recommended Follow-UpPlease share any follow-up you believe may be needed.
