Library Incident / Accident Report
Date of Incident
Time of Incident
Location of Incident
Name of Person Reporting
Date Reported
Library Staff
Person Reporting is:
Patron
Was an outside agency called? If so:
Which Agency?
Police
Ambulance
Other Agency?
Responding officer?
No
Was an arrest made?
Yes
Person(s) Involved
Name
Name
Address
Address
City
City
Phone
Phone
If this was an incident, please provide a description of the perpetrator
Incident Description