Get the Tobacco-Free Incident Referral Form - msubillings

This form is used to refer incidents involving tobacco use to Student Health Services, detailing the person involved and the incident's specifics.

How to fill out tobacco- incident referral form

How to fill out Tobacco-Free Incident Referral Form

1. Begin by entering the date and time of the incident.
2. Fill out the name of the person involved in the incident.
3. Provide details about the location where the incident occurred.
4. Describe the nature of the incident, including any specific behaviors observed.
5. Include any witnesses by noting their names and contact information.
6. Provide any additional comments or notes that may be relevant to the incident.
7. Review the entire form for accuracy and completeness.
8. Submit the form to the appropriate authority or office designated for handling tobacco-free policy violations.

Who needs Tobacco-Free Incident Referral Form?

1. School administrators and personnel handling discipline.
2. Teachers who witness violations of the tobacco-free policy.
3. Health and wellness coordinators in educational institutions.
4. Students who wish to report an incident involving tobacco use.
5. Parents concerned about compliance with tobacco-free regulations.

For pdfFiller’s FAQs

What is Tobacco-Free Incident Referral Form?

The Tobacco-Free Incident Referral Form is a document used to report incidents related to tobacco use on premises where a tobacco-free policy is enforced.

Who is required to file Tobacco-Free Incident Referral Form?

Any staff member, student, or authorized personnel who witnesses a violation of the tobacco-free policy is required to file the Tobacco-Free Incident Referral Form.

How to fill out Tobacco-Free Incident Referral Form?

To fill out the Tobacco-Free Incident Referral Form, one should provide details such as the date and time of the incident, location, names of individuals involved, a description of the incident, and any witness information.

What is the purpose of Tobacco-Free Incident Referral Form?

The purpose of the Tobacco-Free Incident Referral Form is to formally document violations of the tobacco-free policy to ensure appropriate actions are taken and to help maintain a healthy environment.

What information must be reported on Tobacco-Free Incident Referral Form?

The information that must be reported includes the date and time of the incident, the exact location, names of individuals involved, a detailed description of the incident, and any witnesses present.