INCIDENT REPORT

Use the form to report any incident involving client dog(s) that you've experienced or witnessed as an employee at Luke DogWalker. Give as much information as possible.

Name:

First Name

Last Name

Date/Time of Incident:

Location of Incident:

Dog/Client Name

Type of Incident:

Check all that apply

Altercation between dog(s)

Altercation between humans

Other (Describe Below)

Witnesses:

Did anyone see the alleged incident? Give as much information as possible.

Description of Incident:

Please be as detailed as possible

Additional Comments:

Acknowledgement

By submitting this form you acknowledge that what you have described is accurate and if questioned you will cooperate to the best of your abilities. You will not be at risk of losing your job for submitting a claim of harassment or cooperating with an investigation. However, filing a false claim may result in disciplinary actions. If you wish to amend a previous claim, please contact management.