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Student Incident Report Form Template

Streamline Documentation of Student Misbehavior

When disruptive behavior occurs, timely documentation is essential for effective intervention. This student incident report template helps teachers and school officials capture incidents accurately and consistently. By utilizing this form, you can improve communication with parents, ensure compliance with school policies, and track behavioral trends efficiently. With customizable questions and a user-friendly layout, this template is perfect for schools looking to enhance their behavior management strategies. Explore the live template to see how effortless reporting can be.

Your full name
Your role or relationship to the student
I am the student
Parent/guardian
Teacher/staff
Administrator
Counselor
Security/officer
Community member
Prefer not to say
Other
Please Specify:
Email
Phone
May we contact you for follow-up?
Yes
No
Student full name
Student ID or school number (if known)
Grade or year level
Elementary (K-5)
Middle (6-8)
High (9-12)
Undergraduate
Graduate
Other/Not applicable
Unknown
If self-described, enter gender
Student gender
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
Incident date
Incident time
Location of incident
Please Specify:
Did this occur on school property?
Yes
No
Not sure
Type(s) of incident
Please Specify:
How would you rate the severity?
Minor
Moderate
Severe
Not sure
Describe what happened
Is this part of an ongoing pattern or repeated incidents?
Yes
No
Not sure
Other individuals involved (names and roles if known)
Were there witnesses?
Yes
No
Not sure
Witness names and contact information (if known)
Were any staff notified at the time?
Yes
No
Not sure
Was anyone injured?
Yes
No
Not sure
Describe any injuries (location, severity, who was injured)
Was first aid provided?
Yes
No
Not sure
Not applicable
Was medical treatment required?
Yes
No
Not sure
Not applicable
Immediate actions taken
Please Specify:
Reference numbers or links to evidence (if applicable)
Is there evidence available (photos, video, screenshots, notes)?
Yes
No
Not sure
What follow-up would you like?
No follow-up needed
Request contact from school
Meeting with administration
Counseling support
Safety plan or supervision changes
Academic support
Investigation requested
Other
Please Specify:
Type your full name as signature
Date of report
I confirm the information provided is accurate to the best of my knowledge
Strongly disagree
Disagree
Neither
Agree
Strongly agree
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Paper art illustration depicting a student incident report form and related stationery for an article on FormCreatorAI.

When to use this form

Use this form right after any safety, behavior, or injury event on campus, the bus, or during activities. It helps teachers, aides, and administrators capture facts while details are fresh, so you can follow up with families and plan support. Think playground fights, lab accidents, property damage, bullying, or vaping in restrooms. You can model your process on the Ridgewood behavior & incident documentation form to keep records consistent. A clear report speeds decisions on supervision, counseling, and communication, and it protects students and staff by creating a reliable record.

Must Ask Student Incident Report Questions

  1. When did the incident occur, and where exactly?

    Specific time and location help you match camera footage, duty schedules, and other reports. Precise details reduce disputes and speed follow-up.

  2. Who was involved, and how are they connected to the school?

    Listing students, staff, and witnesses with roles ensures correct contact and duty-of-care steps. It also helps cross-check records and any existing plans.

  3. What happened? Describe the sequence of events and any triggers.

    A factual timeline supports fair decisions and reveals root causes. For ongoing patterns, pair your notes with the Behavior observation form to track frequency and context.

  4. What actions did you take during and after the incident?

    Documenting de-escalation, first aid, and guardian notification shows compliance and protects everyone. If policy violations occurred, you may also submit a Discipline referral form to start formal steps.

  5. Were there injuries, property damage, or safety risks, and what evidence is available?

    Notes on injuries, damage, and attachments (photos, statements) guide next steps and insurance. Evidence reduces ambiguity and supports accurate reports.

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