Incident Report Form

Instructions:

Please use this form to report any incidents, concerns, or breaches of our Code of Conduct and Safety Policy. Your report will be handled confidentially, and appropriate actions will be taken to address the situation. If you wish to remain anonymous, please leave the personal information sections blank.

Reporter Information (Optional)

Enter your full name as the person reporting the incident.
This field is required.
Provide a contact number where you can be reached.
This field is required.
Relationship to SIMBA Trainers
Select your relationship to SIMBA Trainers from the options provided.

Incident Details

Please provide the date and time of the incident.
This field is required.
This field is required.
This field is required.
This field is required.
Type of Incident
Select the type of incident from the options provided.
This field is required.

Additional Information

Confidentiality

Would you like this report to remain anonymous?
This field is required.
May we contact you for further information if necessary?
This field is required.
Thank you for helping us maintain a safe and respectful environment at SIMBA Trainers. Your report will be reviewed promptly, and we will take the appropriate steps to address the situation. For any immediate concerns, please contact our Safety Officer.
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