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Begin by entering the consumer’s name, UCI number, and address in the designated fields. Ensure accuracy as this information is crucial for identification.
Fill in the date of birth and sex of the consumer. Select 'Male' or 'Female' as applicable.
Provide details about the vendor or agency name, along with the date of report and admission if applicable. This section helps establish context for the incident.
In the 'Type of Incident' section, check all relevant boxes that apply to the incident being reported. Be thorough to ensure all aspects are covered.
Document specifics such as incident date, time, and location. Include any medical care required and describe the incident clearly in the provided space.
Finally, review all entries for completeness before submitting your report through our platform.
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