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1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Employee Name, Date, Location of Incident, Job Title, and Department in the designated fields.
3. If you are not an Anne Arundel County employee, please provide your Mailing Address.
4. Fill in the Date and Time of the Incident along with a detailed description of what occurred.
5. Indicate any bodily harm or property damage that resulted from the incident.
6. Select all applicable types of incidents from the checklist provided.
7. If a weapon was used, specify the type and note if any threats were made prior to the incident.
8. Complete the section for Supervisory Action Taken and attach any relevant documentation as needed.

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