DOR Incident Report Instructions

Introduction

The Colorado Department of Revenue has over 40 office/facility locations across the state.  From time-to-time situations or incidents happen that may impact the operation of an office or be important to document for use in determining office safety programs, future operational needs and other possible office improvements or modifications.

For this reason, the Facilities, Safety and Security Office maintains records of all incidents that occur on or in DOR owned or leased facilities. Employees at all DOR locations must submit Incident Reports when required. The following information will provide you with the necessary knowledge and resources to know how, when and where to file a report.

Beginning in January, 2022, all DOR Incident Reports must be completed using the Google submission form on the Facilities Intranet page. In prior years, reports were completed on printed paper forms and then scanned or sent through intra-office mail, which often delayed reports for several days, to the Facilities Office, this resulted in unnecessary paper waste, as well as many reports being unreadable, incomplete or incorrect. Moving to a paperless format is in line with the State’s Greening Initiative and provides legible, complete and accurate reporting, as well as the ability to better track and research trends by office. 

Where to find the Incident Report Form

The DOR Incident Report form is located on the Facilities, Safety and Security Intranet under the Safety and Emergency Management page.  Please take a moment to bookmark link below for quicker future access.

DOR Incident Report Form

When do I need to fill out an Incident Report?

As a DOR employee, you have a responsibility to report any situation or incident that can impact the safety of employees, visitors, customers, or the general office environment or operation. The following general categories are available to choose from, most incidents occurring at DOR offices will fall into one of these report types:

Employees are asked to use their best judgement to determine what type of report to submit and are not expected to know the legal definitions of what constitutes a criminal offense versus a non-criminal incident. If you have any questions on what type of report to submit, please contact the Facilities, Safety and Security Office via email at dor_safetyandsecurity@state.co.us for guidance. If you submit a report that is not the correct type, it will be corrected during processing. You should not be asked to re-submit the report unless there are significant errors or corrections that need to be made. 

How to Complete and Submit an Incident Report

The Incident Report Google form is divided into three pages and will walk you through a step-by-step process to fill in all required information and allow you to add specific custom details related to the incident.  Required fields are indicated with a red asterisk and must be answered in order to move to the next page.  All other fields are fillable text boxes to be filled in as necessary, if they do not apply, you may leave them blank.

Page 1:

• Type of Incident. This is a pre-populated drop down box, select the most appropriate report type based on your best judgement and knowledge of the incident.

• Date of Incident. This is the actual date it happened, not the date the report is being completed.

• Street Address of your DOR Location.  Select your office location where the incident occurred from the drop down list. (For State Fleet vehicle accidents, choose the DOR location where the vehicle is permanently assigned and then describe the exact street location/intersection of the accident in the narrative section of the report)

• Approximate Time of Incident. This is just an estimate of when the actual incident occurred if known, not when you were notified of the incident or the time of reporting.

• Name(s) of Witness(es). If there are other employees or customers that may have seen what happened, or were involved, that may need to be contacted by law enforcement or DOR Admin for follow-up information.

• Description of Incident (What Happened). This is probably the most important section, as it provides the facts of what happened and will be used for investigation or follow-up if required. This box is a fillable field and as much detail as possible should be provided, it’s better to provide too much information versus not enough. Small details may not seem that important at the time, but can be very helpful in days, weeks or months later when memories may not be as fresh. If you run out of room in the first box, there is room to continue in the next box or section below.  Use exact words and language when quoting a customer or witness, do not blank out letters due to coarse language or offensive words (e.g. customer told me I was a B****), exact wording is necessary for any police reports or criminal charges that may result from the incident. 

Page 2: If any of the questions on page 2 apply, add as many details as possible. (Some questions require a response)

• Was 911 Called for Police or Medical Services? This is a required field, you must answer “YES” or “NO”.

• Were the Police Called for Non-Emergency Services? This is a required field, you must answer “YES” or “NO”. For example, if you called the non-emergency number to file a police report for theft or damaged property. If the police were already called through 911, then check “NO”.

• If Medical, Name of Patient. The name of the person having the medical issue.

• Is the Patient an Employee? Indicate whether or not the patient is a DOR employee, if an employee, the required OHR injury or medical paperwork will need to be completed on the OHR Intranet page.

• Was an AED (Automated External Defibrillator) Used? Not all offices have AEDs.

• Was Anyone Injured? This is only for observations of obvious injuries or those stated by the individuals, be careful not to attempt to diagnose or determine a person’s injuries (concussion, broken arm, sprained ankle, etc..), leave that to the medical personnel if they are called to the scene.

• Was Anything Stolen? Only report what is known to be missing through your own observations or reported to you as missing, try not to draw any conclusions or accuse someone of taking something, (e.g. a customer said someone stole their wallet, versus, a customer sitting next to the victim stole their wallet). If surveillance video is available it will be provided to law enforcement upon request.  Video footage may not be released or shown to the public without authorization from DOR Leadership or the custodian of security video.

• Were any Suspects Observed? Only report what is observed by you or reported by someone else and provide as much detail as possible about the subject (e.g. male/female, height, weight, race, approximate age, what they were wearing and anything else you can think of). 

Page 3

• Information of the Person Reporting the Incident. This is who is filling out the incident report form, it may not be the person the report is about, it could be the manager or other employee that witnessed it.

• Reporting Person’s First and Last Name. This is needed for tracking and possible follow-up if required.

• Date Reported. This is the date the report is being filled out and submitted, it may or may not be the same date as the incident. It is requested and highly preferred that incident reports are completed and submitted within 24-hours of their occurrence, it’s understood that there may be extenuating circumstances that may delay reporting an incident.

• Reporting Person’s Phone Number. You should provide a phone number where you can be reached if additional information is needed. If you leave an office number, be sure it is a number that will be answered by a live person, not an automated call center or directory bot.

• Reporting Person’s State Email Address. Your State email address.

• Reporting Person’s Relationship to the Incident. Indicate your position or relationship to the incident, (i.e., office manager, victim, witness, etc..)

• Attach any Written Statements, Documents or Photos. This section will allow you to attach photos or written statements or documents relevant to the incident. (photos of damage, police reports, etc..)