WTCSB - Western Tidewater Community Services Board 2026

1. Click ‘Get Form’ to open the WTCSB Incident Report in the editor.
2. Begin by entering the 'Staff Name' and 'Today’s Date' at the top of the form. This information is crucial for identifying who completed the report.
3. Next, fill in the 'Date of Incident' and check all applicable boxes regarding client involvement and incident types, such as 'Client Injury' or 'Traffic Accident Involving agency vehicle'.
4. Specify the location of the incident if it occurred on WTCSB property. If you select 'other', provide an address in the designated field.
5. Identify any safety techniques used during the incident by checking relevant boxes, such as 'Punch Block' or 'Restrain w/ hands from front'.
6. If there were injuries associated with a client, check all applicable injury types listed under that section.
7. Determine and select the appropriate ‘Level’ of the incident based on DBHDS definitions provided in the form.
8. Finally, provide a detailed description of events related to the incident in the space provided at the end of the form.

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