SCHOOL ACCIDENT INCIDENT REPORT All Accidents/Incidents that happen on school campus must be recorded using this form, submissions will automatically go to the administratorsStaff Submitting Form* First Last Email* Date of incident* MM slash DD slash YYYY Time of Incident* : Hours Minutes AM PM Child's Name* First Last Child's Grade*Please ChooseToddler 幼儿班Early Childhood LotusEarly Childhood PeonyEarly Childhood Plum BlossomGrade 1 一年级Grade 2 两年级Grade 3 三年级Grade 4 四年级Grade 5 五年级Grade 6 六年级Grade 7 七年级Grade 8 八年纪Grade 9 九年级Grade 10 十年级Grade 11 十一年级Grade 12 十二年级Description of the incident:Location of the incidentPerson(s) involved in the incident:Witnesses to the incident:Immediate action in responding to the incident:*First Aid treatment given:Who notified parents? Which QAIS staff person notified the student's parents of the incident?What time were parents notified? : Hours Minutes AM PM Which medical facility was the child brought to (If Applicable)?Who accompanied the child to the Medical Facility?