Incident Report Please enable JavaScript in your browser to complete this form. Leader Name * First Last Leader Email * Group Member Name * First Last Group Member Email * This can be found under your Omnify roster when you check people in. Date / Time of Incident * Date Time How did you become aware of this situation? *Member shared in groupMember shared on group boardMember emailed &/or direct messaged meOther (share in details) Type of Incident *Possible endangerment of a group participantPossible endangerment of a child(ren)Other (share in details) Details of Incident * Actions Taken By Group Leader * Follow Up Action Taken (If Any) * Other Pertinent Information * Please attach any screenshots: Screenshot #1 Screenshot #2 Screenshot #3 Screenshot #4 Comment Submit
