Reportable Incidents and Notable Occurrences - bissnybborgb 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'AGENCY COMPLETING FORM' section, ensuring all relevant agency details are accurately entered.
3. Proceed to the 'FACILITY' field if applicable, followed by entering the 'PROGRAM TYPE', 'ADDRESS', and 'PHONE' numbers.
4. Input the 'MASTER INCIDENT NUMBER' and 'AGENCY INCIDENT NUMBER'. If a related incident was previously reported, select YES or NO.
5. Complete the personal information for individuals receiving services, including their name, date of birth, gender, and TABS ID if applicable.
6. Document the date and time of the incident. Specify whether it was observed or discovered, and provide details on when it occurred if known.
7. Select the appropriate preliminary classification for the incident from the provided options.
8. Describe the incident briefly in the designated section. Include any immediate corrective actions taken to safeguard individuals involved.
9. Finally, ensure that all required notifications are documented before submitting your completed form.

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