Get Irts Critical Incident Reporting Form (pdf) - Dhs Mn

Filling out the IRTS Critical Incident Reporting Form is a crucial step in reporting incidents within intensive residential treatment programs. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to access the form and open it in your PDF editor.
2. Enter the facility license number and facility name in the designated fields. Ensure that this information is accurate as it relates to your reporting responsibilities.
3. Provide your name as the person reporting, along with the date of the report and your telephone number for any follow-up.
4. Fill in the date and time of the incident. Be precise with these details to ensure a clear timeline of events.
5. List the treatment director's name. This individual may need to be contacted for further information regarding the incident.
6. Identify all recipients involved by entering their full names. This section is critical for ensuring all parties affected are accounted for.
7. Check the appropriate box under the incident type, selecting all relevant categories such as suicide, attempted suicide, or other specified incidents.
8. If applicable, indicate whether there were any staff involved in the incident, and provide additional details if necessary.
9. In the attachments section, indicate whether you are including any additional pages with your report. Specify the number of pages if you are adding attachments.
10. Provide a detailed summary of the incident, ensuring that it includes all pertinent information. If required, attach related reports to support your summary.
11. Once you have completed all sections, review the form for accuracy. Make any necessary adjustments.
12. Save your changes, and choose to download, print, or share the form as needed before submitting. Ensure you keep a copy for your records.

Complete your IRTS Critical Incident Reporting Form online today to ensure your report is submitted promptly.