Paul Sawyier Public Library Incident Report


TYPE OF REPORT:
TYPE OF INCIDENT:
 
WHEN DID THE INCIDENT OCCUR?
DATE:    (mm/dd/yyyy) TIME:     (example: 5:42 am)
WHERE DID THE INCIDENT/ACCIDENT OCCUR?
 
WHO WAS THE SUBJECT INVOLVED IN THE INCIDENT?
NAME:  PHONE: 
ADDRESS:  LIBRARY CARD #: 
STAFF:    AGE: 
HEIGHT:  WEIGHT: 
HAIR COLOR:  SEX:         
CLOTHING:  TATOOS/SCARS: 
RACE: 

WHAT WAS THE NATURE OF THE INCIDENT?

PLEASE PROVIDE DETAILS OF THE INCIDENT/ACCIDENT, INCLUDING DETAILS OF ANY INJURIES.


WITNESSES

NAME:  PHONE: 
ADDRESS:  LIBRARY CARD #: 

NAME:  PHONE: 
ADDRESS:  LIBRARY CARD #: 

NAME:  PHONE: 
ADDRESS:  LIBRARY CARD #: 

NAME:  PHONE: 
ADDRESS:  LIBRARY CARD #: 

NAME:  PHONE: 
ADDRESS:  LIBRARY CARD #: 

ACTION TAKEN

911
FIRE DEPT
POLICE
AMBULANCE TRANSPORTED BY AMBULANCE:  
POLICE ASSISTANCE (NOT 911)   
SUBJECT REMOVED FROM BUILDING