Dan Flood Elementary School | Ssc Employee Portal

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Incident Report
(Dan Flood Elementary School)

565 N. Washington St. Wilkes-Barre, PA 18702

Please take a moment to fill out the form.

Date (MM/DD/YYYY) * required

Time (00:00am/pm)

Location of incident

Incident Type

If you selected Others

Report prepared by (ENTER YOUR FIRST AND LAST NAME)

Name of Victims/Subject/Suspect

Name of SSCI Officers

Department/Agency

Name of Emergency Personnel (i.e PD. Officer Smith)

What took place (Who, what, where, when, why and how?) PLEASE PUT IN DETAILS WHAT HAPPENED IN 3RD PERSON?

Other Pertinent Information:

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