New Hope Church

Incident Report Form

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Incident Report Form

Incident Report Form

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Incident Report Entry

Added: 1/21/2025

Incident Report Form Instructions:

The information you enter will update or create a profile for the person in the church database. If no phone for the person, enter 000-000-0000. If no email for the person, enter fake@gmail.com .

If you are a staff person with New Hope and have a Rock Login, please make sure you are logged out of Rock when you fill out this form.

NOTE: By completing this form, you hereby certify that the information you are providing about this incident is true, correct, and complete to the best of your knowledge and belief.

Entered By:

First Name of person involved/injured:

Last Name of person involved/injured:

Is the Person Involved Under 18

Yes No

Phone of person involved/injured:

Email of person involved/injured:

Have parents been notified:

Yes No

Affiliation with New Hope:

Staff Member Volunteer Other

Date of Report

Date of incident

Location of incident

Ministry affiliation of person(s) initiating incident (If any):

None Connections Creative Communications Events Finance HR IT New Hope Kids New Hope Students Operations Pastoral Care Production Risk and Safety/ MERT

Detailed description of incident/injury

Witnesses present (if any):

Administrative response taken (If any):

Submit