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Fall Incident Report
When a fall occurs, having a structured report ensures every critical detail is documented. This form guides you through recording the circumstances, injuries, first aid provided, and follow-up actions needed.
Who is this for?
Essential for any caregiver, home health aide, or family member responsible for a senior who is at risk of falls. Also required in many assisted living and home care agency documentation protocols.
How to use
Fill out this form as soon as possible after a fall occurs. Record the senior name, caregiver name, date, and time of the incident. Then work through each field describing where the fall happened, what the senior was doing, any injuries observed, first aid given, and whether emergency services or the doctor were contacted. Complete the follow-up plan and share the report with the care team and healthcare provider.
Fall Incident Report
Frequently Asked Questions
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