Incident Reporting Forms

Revised Incident Reporting UpDoc Instructions, including contact and Reporting Authority assignment information.

Initial Report

• Initial Incident Report
• Initial Report Form Instructions
• Summary Review – Incident Reporting Levels and Categories Grid
• Choking Checklist
• Walkaway Checklist

Follow-Up Report

• UIR Follow-up Report Form (DC 14: Appendix B)
• UIR Follow-up Report Form Instructions

Incident Reporting Category Lists

• Incident Reporting Levels and Categories Grid

Office of Risk Management: Plan of Correction

• Office of Risk Management Plan of Correction Training (revised Feb. 2024)

For use by providers after a DHS Investigation has been completed:

• Plan of Correction Template and Instructions