Officer Safety & Operations Report
***CONFIDENTIAL***
Name (confidential)
*
First Name
Last Name
Mobile Phone*
*
Please enter a valid phone number.
Format: (000) 000-0000.
Personal Email Address
*
example@example.com (not your probation email)
Location of Incident
*
Date and Time of Incident
*
Description of Incident
*
Incident Photos (if any)
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To whom should these photos be attributed (if anyone)?
Were there any call-outs during the incident? If so, please describe (example: 2 out on vacation, 1 out after a 26 hours shift).
*
Do you need representation due to this incident?
*
Yes
No
I'm not sure
Incidents and personal stories are the best way to achieve our goals for safety, staffing, pay & benefits, etc. May Local 685 share your story to help move our collective agenda?
*
Please Select
Yes - with my name
Yes - without my name (anonymously)
Maybe - call or email me directly
No - do not share my story
Submit
Should be Empty: