To submit an incident, please fill out the form below and then click submit. You will be directed to a confirmation page with a summary of your submission.
Section Title
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Medical Details
For incidents including illnesses or injuries, include the following information in the "Report Writer Narrative" section below:
- Patient First Name
- Patient Last Name
- Patient Age
- Chief Complaint (ex. Headache)
- In the past 24 hours, has the patient consumed any drugs or alcohol?
- Medical Disposition (ex. Taken to Med Tent)
- Was the patient taken to the hospital? If "yes", what hospital?
- Ask: "In your own words, please tell me what treatment was provided to you"
- Ask: "In your own words, please tell me what the reason was for you needing treatment"
Property Damage Details
For incidents including property damage, include the following information in the "Report Writer Narrative" section below:
- Name of Individual Causing Damage
- If staff or vendor, who is the individual's employer?
- In the past 24 hours, has the person causing damage consumed any drugs or alcohol?
- Owner of Damaged Property
- Was the owner notified of the damage?
- Owner Contact Info
- Estimated Cost of Damage (USD)
- Description of Property Damage
- Photos of Damage
- Attach photo ID of Individual causing damage
Fire Details
For incidents including fire or smoke, include the following information in the "Report Writer Narrative" section below:
- What was the source of the fire/smoke?
- Who is the owner of the source?
- What was the presumed ignition cause?
- Did the Fire Department respond?
- Fire Department Statement and/or Report Number
- Photos of fire/area
Altercation Details
For incidents including altercations, include the following information in the "Report Writer Narrative" section below:
- Names of Individuals
- Association to Event (ex, Staff, Vendor, or Patron)
- Did any individual cause injury or death?
- Was any individual injured during the altercation? If yes, include "Medical Details" above.
- In the past 24 hours, has anyone involved consumed any drugs or alcohol?
- Was anyone arrested?
- Was anyone trespassed?
- Was anyone evicted?
- Attach photo IDs of all involved
Witness Details
For incidents where there are witnesses, include the following information in the "Report Writer Narrative" section below:
- Witness Name
- Witness Phone Number
- Witness Email
- Ask: In your own words, please describe the incident and how your were involved
- Association to Event (ex, Staff, Vendor, or Patron)
- If staff or vendor, who is the individual's employer?
- Attach photo IDs of witness
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