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IncidentReport form

The purpose of this form is to communicate situations that may impact the welfare of the campus community (students, faculty, staff, and visitors) and campus property.

An employee of Lakeview College of Nursing must submit this form within 48 hours of the incident.

Copies of additional documentation must be sent to Karlee Thomen (Danville campus).

Identify parties as students, faculty, staff, guests, et cetera.
Were LCN policies followed?
Campus
Type of incident
Clinical
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