Template: incident report

ops #template #incident #all-staff

Fill out an incident report for any of: guest injury, staff injury, equipment failure causing service disruption, security incident, customer complaint requiring follow-up, comp over $50, breakage over $100, anything that might involve insurance or police.


Incident report

Date: [date]
Time of incident: [time]
Reported by: [name + role]
MOD on duty: [name]

What happened

[Plain-language description. Who, what, where, when. Stick to facts; do not speculate on cause or fault.]

Who was involved

  • Guest(s): [name(s) if known, otherwise description, contact info if available]
  • Staff: [names of any staff involved]
  • Witnesses: [names]

Injuries / damage

  • [Person] — [injury, treatment provided]
  • [Item] — [damage, value, replacement status]

Actions taken

  • [step 1]
  • [step 2]
  • [step 3]

Photos taken

  • [yes/no, attached to this report]

Authorities contacted

  • [911 EMS / police / fire — yes/no, time, badge if known]

Insurance notification

  • [GM notified — yes/no, when]
  • [Insurance carrier notified — yes/no, when, claim number if assigned]

Follow-up needed

  • [item, owner, deadline]

Signed by reporter:
Signed by MOD:

Filed in daily ops binder, copy to GM same day.