Dch incident report 2026

1. Click ‘Get Form’ to open the dch incident report in the editor.
2. Begin by filling in the facility and county information at the top of the form. Ensure that you provide accurate contact details, including phone, fax, and email.
3. In the 'Type of Incident' section, check all applicable boxes to categorize the incident. This includes options for abuse types, death circumstances, serious injuries, and more.
4. Enter the resident's name(s) along with the date and time of the incident in their respective fields.
5. Provide a detailed description of the incident in the 'Details of Incident' section. If necessary, attach an additional page for more information.
6. Complete the notifications section by listing names and times when family members, physicians, or police were notified about the incident.
7. Fill out details regarding any alleged perpetrators and witnesses, including their names, addresses, phone numbers, and relationships to the resident.
8. Document any immediate corrections or steps taken to prevent further incidents in the designated area.
9. Finally, complete your report by signing it as the reporter and entering your title along with the date and time of submission.

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