Public · free template

Community Incident Report Form

Record public incidents, hazards and complaints with witnesses.

Questions
19
Pages
4
Layouts
classic
Conditional rules
3
Preview it in the gallery

Searches this template answers

About this template

When something happens in a public space, the value of the report depends entirely on how much detail was captured while memory was fresh. This form asks for the reporter's details and their relationship to the incident — involved, witness, staff member or passer-by — then the exact date, time and location. The incident type covers antisocial behaviour, criminal damage, safety hazard, injury, environmental issue, service failure or a complaint about staff conduct, and each is described in a structured narrative box with prompts for what happened, who was involved and what was done at the time. Injury and emergency-service questions branch out only when relevant, capturing whether anyone was hurt, whether police or ambulance attended, and any crime or incident reference already issued. Witnesses can be listed with contact details, and photographs or video can be attached. The reporter confirms whether they are willing to be contacted for follow-up, which lets investigating officers prioritise the reports that can actually be progressed.

What this form asks

Every question is editable — rename it, make it optional, or delete it entirely.

Page 1 — About you

  • Your namerequired
  • Email addressrequired
  • Contact number
  • Your involvementrequired
  • Happy to be contacted for follow-up?required

Page 2 — The incident

  • Incident typerequired
  • Date of incidentrequired
  • Approximate time
  • Location
  • What happened?required
  • How serious do you consider this?

Page 3 — Injuries and response

  • Was anyone injured?required
  • Describe the injuries and any treatment given
  • Did emergency services attend?required
  • Crime or incident reference number

Page 4 — Witnesses and evidence

  • Are there witnesses?required
  • Witness names and contact details
  • Photographs or video
  • Agreementrequired

19 questions in total.

Conditional logic included

  • WhenWas anyone injured?is Yes, requireDescribe the injuries and any treatment given”.
  • WhenDid emergency services attend?is Yes, showCrime or incident reference number”.
  • WhenAre there witnesses?is Yes, showWitness names and contact details”.

Works in this layout

Frequently asked questions

Can staff and the public use the same form?
Yes — the involvement question distinguishes staff reports from public ones so they can be triaged differently.
Is it suitable for accident books?
The injury section captures the essentials; add your regulator's specific fields to make it a compliant record.
Can reports be anonymous?
Make the name and contact fields optional and set the follow-up question to No by default.
How do serious reports get noticed?
Use the severity scale and injury answers to trigger an immediate notification to a duty officer.