Critical Incident Report Form

Report an incident such as an injury, accident, theft, fire, assault or damage.

Questions marked * are required. Current students can also use the Forms page in the student portal.

Your email address *

Date *

Time *

Location *

Detailed information of what activity was taking place when it happened *

Description of injury

Description of incident *

Description of damage

Were any other services involved/attended? *

Yes

Report received by *

Copy of the report

Allowed: .pdf, .jpg, .jpeg, .png, .doc, .docx. Up to 3 file(s), 10 MB each.

If other services attended, please attach a copy of their report.

Including everyone who is somehow related to the incident.

Person/s involved

Your name *

Your contact number