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MHPL Incident Report
Director: Shasta Hochstrasser 208-587-4716 790 North 10th East Mountain Home, Idaho 83647
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* Indicates required question
Date of incident:
*
MM
/
DD
/
YYYY
Time of Incident:
*
Time
:
AM
PM
Reporting parties name & contact information:
*
Your answer
Staff members present:
Your answer
Where on Library grounds did the incident occur?
Your answer
Were there minors involved?
Yes
No
Unsure
Clear selection
Minor's name(s) & Parent/ Guardian name(s) & contact information if known:
Your answer
Persons involved, name(s) & contact information if known:
Your answer
Incident type (please select all that apply):
Illness or injury
Problem patron
Theft or property damage
Vandelism
Acts of violence, aggression or threats
Harassment of employees or patrons
Re-occurring behavioral issues
Sexual misconduct
Children left after closing time
Alcohol/ drug abuse
Weapons
Person was asked to leave the property by staff or law enforcement
Other:
Nature of the problem?
Clearly and in detail, explain what happened to the best of your knowledge. This should include what led up to the event and what happened immediately afterward.
Your answer
Were Police or Emergency Services called?
Yes
No
Clear selection
Staff action taken:
Your answer
Are you a current member of MHPL staff?
*
Yes
No
Thank you
Thank you for taking the time to fill out this incident report. We appreciate your assistance.
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