Incident Report v2

Person, Place, Time


Individual's Initials, last 4 of phone and -21Y

Include code, dash, and anything after the dash.
The form will error out if the Project Code or Timesheet Code are wrong!

mm/dd/yyyy 11:22 AM

Incident Information


Location, town, trail

Describe the incident, materials/people involved, conditions/terrain, etc. AVOID USING THE NAME OF THE PERSON INVOLVED IN THE INCIDENT.  ie. (FCL was injured rather than Greg Ross was injured. Names of others who helped, etc are fine, 


This is an opportunity for the person(s) involved in the incident to debrief with MCC staff.