Get Dish Incident Report Form

Filling out the Dish Incident Report Form is an essential process for documenting incidents accurately. This guide will provide you with clear instructions on how to complete the form online, ensuring that all necessary information is captured effectively.

Follow the steps to complete the Dish Incident Report Form

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter today's date in the designated field to ensure the report reflects the correct timeline.
3. Fill in the date and time of the incident to provide context and accuracy.
4. Input the location of the incident where it occurred, as this information is crucial for record-keeping.
5. Provide the student's name as the individual involved in the incident.
6. Fill in the faculty member's name who was overseeing the incident.
7. Briefly describe the incident, including who was involved, who was present, who was notified, what happened, and the relevant dates and locations.
8. Indicate whether the student or faculty member was wearing gloves at the time of the incident by selecting Yes, No, or N/A.
9. Answer whether goggles, a face shield, or a mask were worn during the incident by selecting Yes, No, or N/A.
10. List the names, addresses, and phone numbers of all witnesses to the incident.
11. Detail any testing or treatment that was provided to the individual involved.
12. Identify any follow-up actions that are planned or were recommended following the incident.
13. Reflect on how this incident might have been prevented to inform future practices.
14. Have the student sign and date the form to acknowledge their input.
15. The faculty member should also sign and date the form before submission.
16. Finally, save your changes, then download, print, or share the completed form as needed.

Complete the Dish Incident Report Form online today to ensure accurate documentation and timely submission.