CLIENT INCIDENT REPORT
Confidential – Internal Record

IMPORTANT

An incident report should be completed as soon as practicable following an incident.

Where there is an immediate threat to life or safety, protecting the person and contacting emergency services takes priority over completing this report. Completion of this form does not replace any mandatory notification or reporting requirements that may apply. Management must determine whether an incident is reportable to the NDIS Quality and Safeguards Commission or another relevant authority.

All incident information must be handled confidentially and stored in accordance with RCC privacy, incident management and record-keeping requirements.

INCIDENT RECORD

1. Incident Details
Please select
Select Type
2. Type of Incident
Select Type of Incident
Select the classification
3.What Happened?
4. Immediate Safety & Response
Select Emergenacy Service
5. Staff Planned Follow-up (only applicable to client service)
Staff Declaration

I confirm that the information recorded in this report is accurate to the best of my knowledge and reflects the information available to me at the time of completing the report.

Document ID: RCC-IR-001 | BOS HQ version 1.0 | Effective: October 2026 | © 2026 Resilience Community Collective