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Policy5114.11 Attachment No.5114.11AR1 PETERSTOWNSHIP SCHOOLDISTRICT ADMINISTRATIVE REGULATIONS STUDENTINCIDENTREPORTFORMA VIOLATIONOFHARASSMENT/SEXUALHARASSMENTPOLICY 1. NameofComplainant: 2. Date(s)/TimesofAllegedIncident(s):
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How to fill out student incident report forms:

01
Begin by obtaining a copy of the student incident report form. These forms are typically provided by the school or educational institution.
02
Fill out the basic information section of the form. This includes details such as the date and time of the incident, the location where it occurred, and the names of any staff members or witnesses present.
03
In the next section, provide a detailed description of the incident. Be concise but thorough, including important details such as what happened, who was involved, and any specific actions or behaviors observed.
04
If applicable, specify any injuries sustained by the student or others involved. Include information on whether medical attention was required or if any follow-up actions were taken.
05
Note any immediate actions taken by the school staff, such as providing first aid or contacting parents/guardians.
06
If there were any witnesses to the incident, obtain their contact information and include it in the relevant section of the form.
07
Finally, be sure to sign and date the form, as well as have it signed by any other staff members involved in the incident or who provided information for the report.

Who needs student incident report forms:

01
School administrators and staff need student incident report forms to document and address any incidents or accidents that occur on school grounds or during school-related activities.
02
Parents or guardians may also need student incident report forms if they want to report an incident or injury that occurred involving their child at school.
03
Depending on the severity or nature of the incident, law enforcement or legal authorities may also require student incident report forms as part of an investigation or legal proceedings.
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