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Date: __________________________________ Student Name: ___________________________ Time of Incident: __________________________ |
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Describe in detail what happened and why, in your opinion, it happened. ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ————————————————————————————————————————
Did anyone else see what happened? ___________________________________________________ Was anyone hurt? _________________________________________________________________ What strategies could have been used in order to avoid this incident? ———————————————————————————————————————— ———————————————————————————————————————— ———————————————————————————————————————— ————————————————————————————————————————
STAFF Notes: _____________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ |
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