Incident Report

Use this form to report an incident to the Leor Operations Team. We will contact you to discuss details of the incident.

Family Incident Report

Your Name*
First Last
Date of Incident*
DD slash MM slash YYYY
Type of Incident*
- Accident or situation where the child required medical attention and/or affected the consciousness of a child
- Abuse or neglect of a person
- Unlawful sexual or physical contact with, or assault of, a person
- The use of a restrictive practice in relation to a person with disability
- Other
Please outline information about the incident
Signature

Phone: 02 9051 0511
Email: learn@leor.com.au

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