VIS Public Incident Report

Public Reporting

This form is designed to feel clear and calm under pressure. Move through it one section at a time and provide the facts you know.

1. Incident basics 2. Incident details 3. Attach files if needed 4. Review and submit

Before You Start

What Happens Next

After submission, VIS receives the report through the incident management workflow for review and follow-up.

Common Details

Start with when it happened, where it happened, and what type of incident you are reporting.

Date Required

Time Required

Location: at VIS? Required

Choose the option that best matches where the incident happened.

Yes No

Type of incident Required

Choosing a type reveals the matching section below and keeps the form focused.

Incident Type

Record who was affected, what happened, and any immediate care or escalation that took place.

Name of injured/ill person

Injured person date of birth

Injured/ill person contact number if known

Injured/ill person’s relationship to VIS

Nature of injury/illness

Cause of injury/illness

Please describe what occurred, with as much factual detail as possible

Details of witnesses or others involved (name, contact info)

Was first aid provided?

Yes No

Was 000 called?

Yes No

Was injured/ill person referred to further medical consultation?

Yes No

Final Step

Ready to submit? Review the details above, then send the report to VIS.

Please verify you're human

Incident Report