Appendix P
Little Dixie Regional Libraries Incident Report Form
Date:___________ Time:_________________
Library:_______________________________
Where in Library:________________________
Staff member assisting:__________________
Name of person filing report:__________________________________
Name of Individuals involved in incident:_______________________________
Police contacted: Yes_____ No______
Police contact information:_________________________________
(Use additional back/additional paper, if necessary)
Description of incident:
Action taken:
Follow-Up Information:
Posted online September 7, 2021