top of page
CACEO Code Official Safety Specialist - City

Incident / Death Report

Please use this form to report an incident related to your employment that may include: verbal threat, death threat, stalking, assault, cyber bullying/stalking, attempted homicide, animal attacks, brandishing weapon, or a death of an official. 

Details, details, details! Please include a summary of what occurred, if a police report was taken, etc. 

Names, agencies, and any personal identifiers will be redacted.

Please be as detailed as possible in your incident/death report.

Type of Incident
Verbal Threat
Death Threat
Brandishing Weapon
Stalking
Assault
Animal Attack
Held Against Will
Attempted Murder
Murder
Biohazard
Other
bottom of page