Norwescon Incident Report Form

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Email *

Date of Incident *

YYYY

Time of Incident *

Time

CAD/Report Number *

During the event request this number from Radio, you can also request a CAD/Report Number from safety@norwescon.org

Location *

Examples: Double Tree Hotel, Virtual Meeting

Room

What Room did this incident take place? Please use what the hotel/venue calls the room. Example: 7108, Olympic 3, Grand Ballroom

Norwescon Location Name

What does Norwescon call this space? Examples: Office, Panel Room, Art Show, etc.

Incident Type *

Report Controls/Routing

Choose any the apply

Confidential

Involving a Minor

INFORMATION ONLY REPORT

Do you want to attach a person to this report? *

Yes

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