DRIVING INCIDENT
REPORT
Submit
Complete form and enter ALL relevant information
Prior to selecting SUBMIT button.
CONTACT On Duty Supervisor
AT (503) 726-3090 IMMEDIATELY
AFTER SUBMISSION
Name *
Email
 
Feedback on your report?
Event Date *
 mm/dd/yyyy
Event Time *
 hh:mm
Event Type
Location and Equipment
# of Passengers
Driver Name
Type of Driving
Driver Lic #
Vehicle ID
During
Based at
PIC Duty Time
Event Details
Event Description (One Sentence Summary) (250 Characters)
Describe the Incident & Sequence of Actions (1500 Characters)
What Different Actions Could Have Reduced or Mitigated Risk
What Additional Resources Could Have Reduced or Mitigated Risk
This Incident May Have Caused a Regulatory Deviation or Violation
This Incident was Non-Compliant with HAA SOP's and/or Policies & Procedures
Attach Images/Files to report:
Add files Start upload

Drag a file and drop it here
* Required field(s)
Submit
CONTACT On Duty Supervisor AT (503) 726-3090
IMMEDIATELY AFTER SUBMISSION