Child Elopement Incident Report Form
Please complete this form to document all relevant details of a child elopement incident. Ensure all information is accurate for operational reporting.
Date and Time of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Incident
*
Child's Full Name
*
First Name
Last Name
Age of Child
*
Name of Person Reporting
*
First Name
Last Name
Witnesses (if any)
Brief Description of Incident
*
Estimated Duration of Elopement (minutes)
*
How was the child located and returned?
*
Actions Taken / Persons Notified
*
Submit Report
Should be Empty: