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Venue Incident Reporting
Venue
Venue Address
Incident Date
Incident Time
Time Incident Concluded
Staff Member Name
Staff Member Role
Contact Email/ Phone
Procedures & Response
Verbal request to floor staff/ Door Staff/ Other Staff
Written note/ Ask for Angela card
Pointing to poster
Other (please specify below):
Immediate Risk Assessment
At the time of the request, was the person:
Calm but uncomfortable
Distressed
Under the influence of alcohol
Under the influence of drugs
Being actively followed / monitored
In immediate danger
Other (please describe):
Brief Description of Situation at First Contact:
Actions Taken by Satff (Select all that Apply)
Moved individual to a safe/private area
Provided reassurance
Contacted manager
Arranged safe transport (taxi / friend collection)
Contacted door staff
Monitored alleged perpetrator
Asked alleged perpetrator to leave
Refused further service
Called police
Called ambulance
Other (please describe below)
Brief Description of Action Taken:
Outcome
Individual left safely with friend
Individual left safely via taxi
Individual remained in venue safely
Alleged perpetrator left venue
Police attended
No further action required
Were Emergency Services Contacted? If so, What Service? Include Reference Number
Safeguarding Follow Up
Incident logged in venue incident book
CCTV secured (if relevant)
Management informed
Further internal review required
Staff debrief completed
Brief Description of Follow Up:
Send