Inmate and Correctional Officer Incident Update Log
Use this form to document correctional facility incidents, the people involved, what happened, actions taken, witnesses, and any required follow-up.
Incident Overview
Incident Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Incident Type
*
Please Select
Verbal Altercation
Physical Altercation
Medical Issue
Contraband Discovery
Rule Violation
Property Damage
Self-Harm Concern
Staff Injury
Inmate Injury
Lockdown Event
Other
Incident Severity
*
Low
Moderate
High
Critical
Incident Summary
Location and Context
Facility or Unit Name
*
Exact Location Within Facility
*
Housing Unit / Block or Area
Shift or Watch Period
*
First Watch
Second Watch
Third Watch
Day Shift
Evening Shift
Other
Incident Status
*
Ongoing
Resolved
Unknown
Involved Inmates and Staff
Number of Inmates Involved
*
Inmate Names or Facility Identifiers
*
Correctional Officer or Staff Names / Badge Labels
Role of Each Person Involved
*
Were Outside Emergency Services Involved?
*
Yes
No
Incident Details and Actions Taken
Detailed narrative of what happened
*
Timeline of key events
*
Immediate actions taken by staff
*
Verbal intervention
Escort
Restraint
Segregation
Medical check
Supervisor notified
Lockdown
Contraband secured
Evidence preserved
Other
Injuries or symptoms observed
No visible injury
Bleeding
Swelling
Bruising
Pain reported
Difficulty breathing
Loss of consciousness
Dizziness
Other
Property or evidence involved
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Witnesses and Follow-Up
Witnesses
Follow-Up Actions Required
Medical Review
Supervisor Review
Disciplinary Report
Maintenance Request
Security Review
Mental Health Review
Investigation
Other
Recommendation for Next Steps
Reporter Name and Role/Title
*
Report Submission Date/Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Final Verification
*
Yes
No
Submit Incident Update
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