Skip survey header

Incident Report

This incident report is for program monitoring purposes. The team leader is expected to complete an incident report for any incident during the trip. This does not take the place of the H.E.A.L. hotline for safeguarding issues. Any volunteer, staff member, or community member can submit a safeguarding issue or concern to the H.E.A.L. hotline.
1. Date and time of incident *This question is required.
This question requires a valid date format of MM/DD/YYYY.
calendar
4. Team Leader *This question is required.
This question requires a valid email address.
6. Incident Type *This question is required.
7. Where did the incident occur? *This question is required.
9. Was first aid/medical assistance provided on site? *This question is required.
9. Was the volunteer taken to a medical facility? *This question is required.
9. Was the travel assistance provider called? *This question is required.
9. Were expenses incurred? *This question is required.
9. In the event of an incident requiring a police report, was a report filed? Be sure to send a copy to the sending coordinator for this trip. *This question is required.
0%
Privacy | Terms of service | Habitat.org

© 2017 Habitat for Humanity® International. All rights reserved. "Habitat for Humanity®" is a registered service mark owned by Habitat for Humanity International. Habitat® is a service mark of Habitat for Humanity International. Habitat for Humanity® International is a tax-exempt 501(C)(3) nonprofit organization. Your gift is tax-deductible as allowed by law.