Free High School Incident Report Template
High School Incident Report
I. Incident Report Details
Incident Number: 2050-05-20-001
Date of Incident: May 20, 2050
Time of Incident: 2:30 PM
Location: High School Gymnasium
II. Reporting Staff Information
Name: [Your Name]
Position: Physical Education TeacherType of Incident: Physical Altercation
III. Involved Parties
Student 1: Jane Smith, 11th Grade, Age 17
Student 2: Sarah Johnson, 11th Grade, Age 17
IV. Summary of Incident
At approximately 2:30 PM during a scheduled PE class, an altercation occurred between the two students. The incident began when a disagreement over the rules of a basketball game escalated into a physical confrontation. Jane reportedly shoved Sarah, who retaliated by pushing back. The altercation lasted for about one minute before staff intervened.
V. Witness Statements
Witness 1: [Witness 1 Name]
Statement: "I saw both of them arguing over a foul call. Jane got upset and pushed Sarah. Jane pushed back, and then the teacher stepped in to stop them."Witness 2: [Witness 2 Name]
Statement: "It happened so fast. One minute they were yelling, and the next, they were pushing each other. The teacher broke it up quickly."
VI. Actions Taken
Immediate Response: The incident was immediately de-escalated by the PE teacher. Both students were separated and taken to the school's nurse for a check-up.
Disciplinary Measures: The school administration was notified, and both students were sent to the principal's office for further evaluation. The parents of both students were contacted.
Follow-Up: A meeting with the students, their parents, and the school counselor is scheduled for May 21, 2050, to address the conflict and discuss appropriate behavioral expectations.
VII. Injuries Sustained
Student 1: Minor bruising on the left arm.
Student 2: Slight redness on the right shoulder.
VIII. Recommendations
Counseling: Both students should attend conflict resolution sessions with the school counselor.
Supervision: Increased supervision during PE classes to prevent similar incidents.
Educational Session: Organize a workshop on sportsmanship and conflict resolution for the entire 11th grade.
