Free template
Incident and injury report template
The form you hope to use twice a year and need to be right both times. What happened, what you did about it, who you told, and a signature line for the parent.
- Facts first: child, date, exact time, and location, with no room for vague phrasing
- Separate blocks for what happened and the care given, so the record does not blur them
- A notification block with time, method, and who you reached
- Staff and parent signature lines with a date beside each
PDF, one page, letter size. Print a stack and keep them where the first aid kit is.
Get the template
Tell us where to send it and the file is yours. We send the template and the occasional new one, nothing else.
Six blocks, in the order you will fill them
Child and time
Name, date, exact time, and where in the program it happened. Precision here is what makes the rest credible.
What happened
Plain description of the sequence. Write what you saw, not what you assume, and name the other child only if your policy allows it.
Care given
First aid, who provided it, and how the child responded afterward. Includes a line for anything you did not do and why.
Who was notified
Parent or guardian, time and method, plus any call to emergency services or your licensor.
Witnesses and follow-up
Staff present, and what you will do differently. Inspectors read this part to see whether the program learns.
Signatures
Staff, director, and parent, each with a date. A refused signature gets noted rather than left blank.
Fill it the same day, every time
An incident report written a day later is a memory, not a record. The habits below are what keep the form useful if anyone ever asks about it.
Care for the child first, then write. But write before you leave. Twenty minutes after is fine, tomorrow is not.
Stick to observable facts. Fell from the second step of the climber and landed on his left knee, not was being careless.
Tell the parent in person and on paper. The conversation at pickup matters more than the form, and the form is what proves it happened.
Incident reports, answered
Do we file a report for every scrape?
Follow your own policy and your state's rules. Many programs document anything requiring first aid, anything to the head, and anything a parent would want to know about, and keep a simpler log for minor bumps.
Who else needs a copy?
The family always. Some states require notifying your licensor within a set window for serious injuries. Confirm the threshold and timeline that applies to you before you need it.
What if the parent refuses to sign?
Note the refusal, the date, and the staff member who asked, and keep the report. A signature is a receipt, not the record itself.
Can we keep these digitally?
Usually yes, if the record stays complete and available. Ask your licensor whether they need a signed paper copy or accept a scan.
Log it once and the family has it before pickup
Incidents recorded in the app timestamp themselves, reach the parent immediately, and stay searchable if the question comes up months later.