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Incident Report Form

WITHIN 24 HOURS of any incident: 

  1. Complete this report and upload the Annual Permission Form or Girl Health History Form for Council Programs using the upload tab at the bottom of this form or email to Customer Care. or mail: ATTN Membership Manager, Girl Scouts of Hawai`i, 410 Atkinson Drive, Suite 2E1, Box 3, Honolulu, HI 96814.
  2. Send a duplicate of all documents to your Service Unit Manager. 

For COVID-19 Incidents please include the roster for all Adults and Youths in attendance.  Troop & SU events, submit copies of the COVID-19 Waivers for all attendees to Customer Care

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 Injury incident
 Non-injury incident
 Covid-19 Incident

Report Contact Information

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Injury/Incident Details

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Treatment

 
 
 
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Upload additional information and forms

 

 

Report Property Damage Information

(if applicable) 

In the event of property damage complete the property damage report section.

 

Contact name and number damage reported to:

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Follow the Emergency Contact Card Information for detailed instructions of when to report to Council and whom to contact.