Authorization Number : 580-0903
Agency Series No. : ADM-09H
Status : Active
Agency Web Link :
Agency : DMH
Confidential Description : N/A-Load
Division :
Vital Description :
Section :
Record Title : MAJOR INCIDENT REPORTS & SUPPORTING DOCUMENTATION
Revision : 0
Record Description : Form which gives detailed information about major incidents or accidents involving a patient, employee, visitor, or volunteer. Also includes any other supporting documentation showing investigations/actions taken on the incident. May also include the Telephone Report of Incidents form.