Library Incident Report Form
Reported by
*
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Other Staff Witnesses (if any)
Date
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Month
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Day
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
Location
Patron Type
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Name of Patron(s) Involved (if known)
Details of Incident
*
Name of Manager Notified
Action Taken
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Reported to Manager Only
Reported to Security
Other Action Taken
Describe Other Action Taken
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