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Fanwood Memorial Library Policy Manual
Section: Library Operations

Subject: 2.14 Incident Report

Policy

Download a Word Document copy of the Incident Report HERE

FANWOOD MEMORIAL LIBRARY INCIDENT REPORT

Complete the following report for any accident/injury involving a patron occurring on Library premises.
IMPORTANT: This report should be sent or presented to the Library Director or library representative within 24 hours of the accident/injury.


Date: ____________________       Time: ____________________


Name:  ____________________________________________________________


Address:  __________________________________________________________


Phone:  __________________________    Email:  __________________________


Location of incident:  ____________________________________________________________


Describe Event:  _______________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________


Were the Police or Rescue Squad summoned: _________ Was a Police Report Filed:_________


Staff Members Present at time of Incident:  __________________________________________


 ___________________________________________________________________________


Eyewitnesses to accident:

Name                                                      Age           Address                            Phone No.

__________________________     ______     __________________   ____________________

__________________________     ______     __________________   ____________________


Name of person completing form:  ________________________________  Date:  ___________

Additional information or comments:





Board of Trustees
Approved: June 8, 2009
Revised: February 8, 2016


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