Free Daycare Form

Child Incident Report

Complete online, then print or save as a PDF. Information entered here is not saved to CubbyTrack.

Child Incident Report

Childcare Center Documentation

CubbyTrack.com

Basic Information

Childcare CenterClassroom / GroupChild's Full NameStaff Completing Report

Incident DateIncident TimeLocation

Incident

FallBiteCut / ScrapeBump / BruiseIllnessBehaviorOther

What Happened?

Injury / Area AffectedFirst Aid / Care Provided

Notification & Follow-Up

Parent / Guardian NotifiedDirector NotifiedEmergency Services ContactedMedical Attention Recommended

Parent / Guardian Notified AtNotified By

Follow-Up Notes

Staff Signature / Date

Parent / Guardian Signature / Date

Director Signature / Date

© 2026 Rizenware Software, LLC. Free form provided by CubbyTrack.com.

More Free Forms