Theater Incident Form
Please use this form to report and document any incidents that occur within the theater. Complete all required fields for accurate follow-up.
Date of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time of Incident
Hour Minutes
AM
PM
AM/PM Option
Location within Theater
*
Type of Incident
*
Safety concern
Injury
Patron behavior
Technical issue
Property damage
Other
Name of Person Reporting Incident
*
First Name
Last Name
Contact Information
*
Description of Incident
*
Were there any injuries?
*
Yes
No
Injury details
Actions Taken
*
Submit Incident Report
Should be Empty: