Follow the steps to fill out the OPWDD Form 163 effectively.

1. Click the ‘Get Form’ button to access and open the OPWDD Form 163 in the designated online editor.
2. Enter the agency name at the top of the form. Ensure that this is the name of the organization that operates the services related to the reportable incident.
3. Fill in your name under 'Person Completing Form.' This identifies the individual responsible for this report.
4. Specify the investigating entity. Choose from options such as OPWDD, Justice Center, or another relevant agency.
5. Document the date of the incident in the provided space, ensuring accuracy.
6. If the investigating entity is OPWDD or the Justice Center, indicate the date this form was provided in the designated field.
7. Add the name of the person investigating the report in the indicated section.
8. Record the OPWDD Master Incident number, Agency Incident number, and Justice Center Case number in their respective fields.
9. Under 'Name of Individual Receiving Services,' enter the full name of the person involved in the incident.
10. Select whether the individual is the subject of the report or a potential witness by checking the appropriate box.
11. If applicable, note the date the individual receiving services was identified as an additional subject or potential witness.
12. Fill in the name of the personal representative and specify their notification status. Options include 'Object to notification,' 'No personal representative,' 'Does not wish to be notified,' or 'Other.'
13. Document the employee's name who attempted the notification, including the date and method of contact used (in person, via phone, other).
14. Indicate whether a personal representative was notified by selecting 'Yes' or 'No.' If applicable, state that the personal representative will participate in the interview.
15. Review all entries for accuracy and completeness before submitting.
16. Save changes, download a copy, or print the form. You can also share it as needed.

Complete the OPWDD Form 163 online today to ensure timely reporting and compliance.