1-8 Incident Report Form - Services for People with Disabilities - dspd utah 2025

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The document is an Incident Report Form used by the Utah Division of Services for People with Disabilities (DHS-DSPD). It requires detailed information about incidents involving individuals receiving services, including personal details, incident specifics, actions taken, and involved parties. The form addresses various types of incidents such as injuries, abuse, criminal acts, and medication errors, and includes sections for documenting follow-up actions and recommendations.

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How to use or fill out 1-8 Incident Report Form - Services for People with Disabilities - dspd utah

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Click ‘Get Form’ to open it in the editor.
Begin by filling in the 'PERSON’S ID' and 'PERSON’S NAME' fields. Ensure all required fields are completed accurately.
Enter the 'TODAY’S DATE', 'DATE INCIDENT STARTED', and 'TIME INCIDENT STARTED'. Use the dropdowns for easy date selection.
Provide your name, the incident's end date and time, and details about when the support coordinator was notified.
In the section for 'NUMBER OF PEOPLE INVOLVED', list all individuals involved, including their roles. This is crucial for clarity.
Indicate where the incident took place by selecting from options like 'School' or 'Friend’s Home'.
Detail any actions taken post-incident, including notifications to medical professionals or police.
Finally, describe the incident in detail, ensuring to include how each person was involved. Sign and date where indicated.

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