SSTUWA - State School Teachers' Union of Western Australia

Date of Incident Select Date

Describe the incident (2000 chars left) *

Where the police called? Yes No *

Details of Assailants Identify or describe assailant. *

Relationship to school Student Ex-student Parent Sibling Staff Member None *

Injuries sustained

Medical Attention Yes No *

Counselling Sought Yes No *

Legal Action Yes No *

Incident reported to: Principal/Manager
OSH Rep
District Office (by Principal)
Union Rep
Not Reported
*

Response or resolution *

Are you happy with the outcome Yes No *

Would you like the union to contact you? Yes No *

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