Sample Incident ReportMajor Injury or Illness - Disabled Sports USA 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the 'Date of Incident' and 'Time of Incident' at the top of the form. Ensure these details are accurate for record-keeping.
3. Fill in the 'Chapter Name' and 'State' fields, followed by the contact information for the Executive Director.
4. In the 'Injured Person Information' section, provide all required details such as name, phone number, gender, address, and date of birth. If applicable, indicate if the injured person is a participant, employee, or volunteer.
5. Detail the injury by selecting from options provided under 'Primary Injury Resulting from Incident' and specify which body part was injured.
6. Describe the incident thoroughly in the 'Description of Incident' section. Include names, roles, location, and sequence of events.
7. Document any response to the incident in the corresponding section. List treatments provided and who administered them.
8. Complete witness information and reporter’s details at the end of the form before submitting.

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