Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Date/Time/Location of incident:
Statement of what occurred. Cite every detail you can remember and use direct quotations
wherever possible. CAUTION: Do not question a child for more information than they volunteer.
Leave that for trained officials.
On the back of this sheet, list names and contact information of persons who witnessed the
incident.
This is a sample form. It needs to be modified to meet the specific needs of your congregation. For information
about creating policies and procedures for the safety of children and youth, please see Safe Sanctuaries, Safe
Sanctuaries for Youth, or Santuarios Seguros published by Discipleship Resources.