| Small Groups Online

Leader Name *

First

Last

Leader Email *

Group Member Name *

First

Last

Group Member Email *

This can be found under your Omnify roster when you check people in.

Date / Time of Incident *

Date

Time

How did you become aware of this situation? *

Type of Incident *

Details of Incident *

Actions Taken By Group Leader *

Follow Up Action Taken (If Any) *

Other Pertinent Information *

Screenshot #1

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Screenshot #2

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Screenshot #3

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Screenshot #4

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Incident Report