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6. APPENDICES Appendix B Sample forms Assault incident report form Note: This type of form can be used to report any threatening remark or act of physical violence against a person or property, whether.

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How to fill out the Assault Form online

Completing the Assault Form online is a crucial step in documenting any incidents of violence or threats you may have experienced or witnessed. This guide provides a clear, step-by-step approach to help you fill out the form accurately and effectively.

Follow the steps to complete the Assault Form online

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the date of the incident in the appropriate fields for the year, month, and day of the week.
  3. Indicate the location of the incident. You may also provide a map or sketch on the reverse side if necessary.
  4. Fill in the victim's name and select their gender from the options provided.
  5. Describe the victim's role, selecting from options such as employee job title, client, or visitor and include the assigned work location if applicable.
  6. Indicate if the victim is a member of a labor organization.
  7. Specify whether the supervisor has been notified about the incident.
  8. Provide a detailed description of the assault incident, including any relevant context or background.
  9. List any witnesses to the incident, including their names and contact numbers.
  10. If applicable, describe whether the assault involved a firearm or another type of weapon.
  11. Indicate if the victim was injured and provide details of their injuries.
  12. Identify who was responsible for the assault by selecting the relevant option.
  13. Specify the gender of the person(s) who committed the assault.
  14. Check any risk factors that pertain to the incident, based on your organization's guidelines.
  15. Consider what steps could be taken to prevent similar incidents in the future, being mindful of the sensitivity of this information.
  16. After all fields are complete, save your changes, and choose to download, print, or share the form as needed.

Complete your Assault Form online today to ensure your incident is documented and addressed properly.

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-Any person subject to this chapter who commits or causes sexual contact upon or by another person, if to do so would violate subsection (a) (rape) had the sexual contact been a sexual act, is guilty of aggravated sexual contact and shall be punished as a court-martial may direct.

(c) While a sexual assault victim may disclose information to whomever he or she chooses, an official report is made only when a DD Form 2910 is signed and filed with a SARC or SAPR VA, or when a Military Criminal Investigative Organization (MCIO) investigator initiates an investigation.

DD Form 2911 (Sep 2011). Forensic Medical. Report: Sexual Assault Examination.

The DD Form 2910 explains the reporting options available to victims of sexual assault and is the form by which a victim makes an official report (either Restricted or Unrestricted). The DD Form 2911 records the findings of the Sexual Assault Forensic Examination (SAFE) and is part of the SAFE kit.

The DD Form 2965 is a tool that SARCs and SAPR VAs can use to capture information to be entered into DSAID when direct data entry is not possible. A Memorandum of Understanding (MOU) is used between organizations to represent an understanding to share specified information within an given timeframe.

DD Form 2910, "VICTIM REPORTING PREFERENCE STATEMENT"

DD Form 2910, "Victim Reporting Preference Statement" Sexual assault reporting procedures require that the SARC be notified of all incidents of reported sexual assault.

The Safety Assessment Tool is designed to evaluate current suicidal/homicidal behaviors in alleged perpetrator(s) or in victims of sexual assault who are at risk. Need to provide a victim of sexual assault a safety assessment plan? Use this worksheet.

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