Critical Incident Reporting Guide 2026

1. Click ‘Get Form’ to open the Critical Incident Reporting Guide in the editor.
2. Begin by entering the member's name, identification number, and contact information in the designated fields. Ensure accuracy as this information is crucial for follow-up.
3. Fill out the reporting individual/agency contact information, including your name, title, provider type, and agency details. This helps establish accountability.
4. Indicate the dates related to the critical incident: when it was discovered, when it occurred, and when Horizon NJ Health was notified. This timeline is essential for proper documentation.
5. Check all applicable primary medical complexities and types of critical incidents from the provided options. This categorization aids in understanding the severity of the situation.
6. In the narrative section, provide a detailed description of the incident, including immediate actions taken and any referrals made. Clarity here can significantly impact response efforts.
7. Review all entries for completeness and accuracy before submitting. Once finalized, fax the completed form along with any supporting documents to Horizon NJ Health Quality Management Department.

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