Get Cfs119 Form

Completing the Cfs119 Form online is essential for documenting unusual incidents accurately. This guide provides a step-by-step approach to ensure that you fill out each section correctly and efficiently.

Follow the steps to complete the Cfs119 Form online.

1. Click ‘Get Form’ button to acquire the form and open it in the editor.
2. Fill in the date and time of the incident in the specified format, using military time, and leave the UIR Incident Number blank for the initial report.
3. In Part 1, enter the involvement codes for each person involved in the incident. Make sure to register each individual separately with their full names, birth dates, and docket numbers where applicable.
4. Provide the assigned worker's information, including their name, ID number, agency, and team. This step is required if a worker or investigator has been assigned to the involved parties.
5. List the placement or facility information, including the provider ID, name, address, telephone number, and living arrangements.
6. In Part 2, check all applicable incident types, such as death, abuse, neglect, and criminal acts. Be thorough in selecting all relevant options.
7. Provide a narrative summary of the incident in Part 3, detailing who was involved, what happened, and where it took place. Include contact information for witnesses and any immediate actions taken.
8. Complete Part 4 by entering the name, title, case manager ID, telephone number of the reporter, and the date the report was completed.
9. Ensure all information is accurate and complete before saving your changes. You can then download, print, or share the completed form as needed.

Start filling out the Cfs119 Form online now to ensure accurate reporting of unusual incidents.