Police Incident Report
Report Date:
State:
Reporting Officer:
Severity:
SECTION 1: INCIDENT DETAILS
Reporting Officer Name: ________________ Badge Number: ________
Date of Incident: ________________ Time of Incident: ________
Location: ________________________________
Incident Classification: ________________
Severity: ________________
Description of Incident:
________________________________
Immediate Actions Taken:
________________________________
SECTION 2: PEOPLE INVOLVED
SECTION 3: WITNESSES
No witnesses identified.
SECTION 4: ROOT CAUSE & CORRECTIVE ACTIONS
Contributing Factors:
________________________________
Root Cause:
________________________________
Corrective Actions:
________________________________
Preventive Measures:
________________________________