Incident Report Form Incident Report Form

Incident/Claim Reporting Form
When an incident arises at the chapter causing any bodily injury or property damage to any person, the following information must be obtained immediately. This report is being completed for submission to our attorney, so please be thorough. If the bodily injury is of a serious nature, please call Executive Director Phil Josephson at 816-891-9200 ext. 18, or fax to 816-891-9401.

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