State notification of a Sentinel Event is required within one (1) business day of discovery 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by selecting what is being reported: either 'Sentinel Event' or 'Near Miss'. Fill in the corresponding dates and times as required.
3. Enter today's date, facility name, reporter's name, title, telephone number, and email address in the designated fields.
4. Provide a brief description of the event, including its location. Ensure this section is detailed for clarity.
5. Indicate the patient's age and gender. Also, include the admitting diagnosis in the appropriate fields.
6. Answer whether this event meets NQF criteria by checking 'Yes' or 'No'. If yes, continue on the back of the form.
7. Select the type of event being reported from the provided options. Make sure to check all that apply.

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