Incident Report

Use this form to report accidents, injuries, medical situations, criminal activities, traffic incidents, or student behavior incidents. If possible, a report should be completed within 24 hours of the event.

ATTENTION: Please add the first name, last name and email of the primary person involved in the incident below where it says, "Your name."

Your name *

Email address *

Phone number

Share best contact number for primary person involved.

Are they a member or regular attender at One Life Christian Church *

Share membership status of the primary person involved in the incident.

Is there another person involved in this incident? *

You don't have to include the second person involved if you feel it is not necessary.

Incident Overview

How many incident submissions has the primary person involved had, including this one? *

If you are unsure please review Planning Center People or select number 1.

Time of incident *

Please share the estimated time the incident took place. For example, in the morning around 9:30 AM

Reporter Information

First Name *

Last Name *

Email Address *

Phone Number *

min: 1000000000 / max: 99999999999

What is your role at One Life? *

Where were you serving at the time of the incident? *

Date of submission *

Do you affirm that this report is accurate to the best of your knowledge? *

A copy of your responses will be sent to your email address.