CAMO RESCUE INCIDENT REPORT
Use this form to report accidents, injuries, medical situations, criminal activities, traffic incidents, or volunteer behavior incidents. If possible, a report should be completed within 24 hours of the event.
Person Involved First Name
Person Involved Last Name
Email
Phone Number
Address
Date of Report
Date Incident Occurred
Time Incident Occurred
Location Where Incident Happened
Name of Dog(s) Involved
Describe the Incident
Was anyone injured?
Yes
No
Unknown
If yes, describe the injuries.
Were there witnesses to the incident? If yes, enter the witnesses' names and contact info.
Were Police notified?
Yes
No
If yes, was a report filed?
Was medical treatment provided? If so, please explain.
Your Signature
*
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This Incident Report was reviewed by:
Follow-up action taken:
CAMO Representative Signature
*
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Submit