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Normal EMS Policy & Procedure Manual MISCELLANEOUS POLICIES MODULE 104 Unusual Occurrence Report Name: Date of Report / / Agencies Name: Incident Date: / / Incident Time: Unit #: Contact #: Location:
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How to fill out 104 unusual occurence report

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How to fill out 104 unusual occurrence report:

01
Begin by collecting all relevant information about the unusual occurrence. This may include the date, time, location, and description of the event.
02
Clearly explain the nature of the unusual occurrence and provide any necessary background information.
03
Use specific details and objective language to describe the sequence of events leading up to and following the occurrence.
04
Include any relevant observations, witness statements, or supporting documentation that may help in understanding the situation.
05
Consider the potential causes or contributing factors to the unusual occurrence and provide any available information on this matter.
06
Include any immediate actions taken to address the occurrence, such as emergency response or mitigation efforts.
07
Assess the impact or potential consequences of the occurrence, including any injuries, property damage, or disruptions caused.
08
Provide your contact information and any additional resources or references that may be helpful for further investigation or follow-up.
09
Double-check the report for accuracy, clarity, and completeness before submitting it to the appropriate authority.

Who needs 104 unusual occurrence report:

01
Organizations or companies that have established incident reporting procedures and protocols.
02
Regulatory bodies or government agencies responsible for oversight and compliance.
03
Healthcare facilities or hospitals where patient safety and quality assurance are critical.
04
Law enforcement agencies investigating incidents or unusual events.
05
Aviation, transportation, or shipping industries where safety and accident prevention are paramount.
06
Engineering or construction firms that require incident reporting for project accountability and risk management.
07
Educational institutions, particularly those with safety or security programs in place.
08
Any organization or individual looking to analyze patterns, identify trends, or improve processes based on reported unusual occurrences.
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The 104 unusual occurence report is a form used to report unexpected or abnormal incidents that may affect a company's operations or safety.
Employees or personnel who witness or are aware of an unusual occurrence are required to file the 104 unusual occurence report.
To fill out the 104 unusual occurence report, one must provide details of the incident, including date, time, location, individuals involved, and any actions taken.
The purpose of the 104 unusual occurence report is to document and investigate unusual incidents in order to prevent future occurrences and ensure safety measures are in place.
Information such as the nature of the incident, potential impact on operations, and any corrective actions taken must be reported on the 104 unusual occurence report.
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