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WOTTHC Incident Report Form
For anything more serious than a Band-Aid, please fill out and submit the form below immediately following the incident.
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* Indicates required question
Date of Incident
*
MM
/
DD
/
YYYY
Hike Leader/Volunteer's name
*
Your answer
Injured person's full legal name and Facebook name
*
Your answer
Location of incident
*
Your answer
Time of incident
*
Time
:
AM
PM
Evacuation?
*
self evacuated
escorted out
rescued/emergency services called
Authorities called (if applicable):
ambulance
rescue team
police
other (explain below)
Clear selection
Witness contact information:
*
Your answer
Description of incident
*
Your answer
Action taken
*
Your answer
Requires follow up from admins?
*
yes
no
Anything else you want us to know?
*
Your answer
Submit
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This form was created inside of Women of the Triangle Hiking Club.
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