Incident Report Form Options
Incidents and accidents may involve moderate to major physical injuries of participants and/or program staff, behavioral issues, or hospital/doctor visits. A person having cause to believe that a minor’s physical or mental health or welfare has been adversely affected by abuse, neglect, or other maltreatment by any person shall immediately make a report to local law enforcement. Please submit the following information within 24 hours of any incident involving injury to or affecting the health or safety of a participant. [1]
[1] In addition to submitting this incident report, immediately call Sgt. Rodger Paxton in the University Police Department at 979-845-8895 (office), 979-574-6179 (cell) for any incident involving physical violence causing substantial injury (assault), weapons used in the commission of a crime, rape, fondling, date rape drugs or other substances used to facilitate a crime, or predatory behavior. The call is to initiate Clery daily crime log disclosure and crime alert evaluation and will not generate a police response.
Please select the appropriate incident report form depending on which of the following roles best suits you. Please note, program staff must use the Program/Event Directors/Staff Incident Report portal to submit incident reports.
This incident report form is for anyone affiliated with staffing a youth program, including all CPM program directors, CPM sponsors, CPM staff, and volunteers.
This incident report form is for any faculty or staff who are not affiliated with a specific program but would like to report information regarding youth to our office.
This incident report form is for any guest of a youth program or event, including parents, youth, and any guests of Texas A&M.

