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EXPLANATION OF INCIDENT ARIZONA DEPARTMENT OF EDUCATION CERTIFICATION UNIT Mailing Address:P.O. Box 6490, Phoenix, AZ 850056490Telephone: (602) 5424367If you have answered “Yes to a Background Question
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How to fill out explanation of incident form

01
Start by clearly describing the incident and its details.
02
Include the date, time, and location of the incident.
03
Provide any relevant context or background information.
04
List any witnesses or individuals involved in the incident.
05
Outline the actions taken immediately after the incident occurred.
06
Document any injuries, damages, or other consequences resulting from the incident.
07
Attach any supporting evidence or documentation, such as photographs or medical reports.
08
Summarize the incident and its impact.
09
Sign and date the form to confirm its accuracy and completeness.

Who needs explanation of incident form?

01
Anyone involved in an incident, such as employees, customers, or visitors, may need to fill out an explanation of incident form. This includes individuals who witnessed the incident or were directly affected by it.
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An explanation of incident form is a document used to provide details about an incident that has occurred, typically related to safety, compliance, or reporting requirements.
Individuals or organizations involved in the incident, such as employees, supervisors, or management, are typically required to file the explanation of incident form.
To fill out the explanation of incident form, provide details including the date and time of the incident, involved parties, a description of what occurred, and any actions taken following the incident.
The purpose of the explanation of incident form is to document incidents accurately for record-keeping, analysis, and to improve safety measures and compliance with regulations.
The information that must be reported includes the date and time of the incident, location, description of the incident, individuals involved, and any witnesses, as well as actions taken in response.
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