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2. Each Incident Report will be taken seriously. Reports will be screened and investigated by Department Managers and Council Members NOT involved in incident.
4. Today's Date*
   Today's Date
6. Incident Date and Time*
   Incident Date and Time

   Incident Date and Time
8. Incident Location*
10. Employee(s)/Council or Commission Member(s) Involved*
12. Description of Incident*
14. Report may be made anonymously or you may request contact. Please complete below IF you would like contact:
16. Name
17. Email Address
19. Phone Number
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

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