Incident Report Submission
LOOMI – Loomex Operational Oversight & Management Interface
IR Form
Activation Information
Activation
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Hub / Host Site
*
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Required
Incident Details
Incident Title
*
Required
Incident Date
*
Required
Incident Time
*
Required
Incident Type
*
-- Select --
Domestic Dispute
Verbal Conflict
Physical Conflict
Intoxicated Individual
Medical Emergency
Medical Non-Emergency
General Mischief
Theft/Property Damage
Missing Person
Fire / Smoke
Hazardous Material
Unauthorized Entry / Trespass
Noise Complaint
Animal Complaint
Other
Required
Location
Street Address
Cross Street 1
Cross Street 2
Prognosis
*
Worsening
Improving
Stable
Unknown
Required
Severity
*
Major
Moderate
Minor
Unknown
Required
Incident Status
*
Major Assistance Required
Assistance Required
Under Control
Resolved
Closed
Unknown
Required
Casualties
Fatalities?
Yes
Fatality Details
Injuries?
Yes
Injury Details
Community Members Involved?
Yes
Details
Supporting Agencies
Police
Ministry of Natural Resources
Fire
Ministry of Labour
EMS
Ministry of Environment
Animal Control
Provincial HUSAR Team
Bylaw
Provincial Hazmat Teams
Ministry of Emergency Preparedness and Response
Other
Lead Agency
Narrative
Related Events
Situation Summary
*
Required
Anticipated Actions
Supporting Documents
📎
Click to attach files
Images, PDFs, Word, Excel – up to 5 files
Incident Commander Information
Site Commander Name
*
Required
Department
Contact Phone Number
Completed By
Name
*
Required
Position
Contact Phone Number
Date Completed
*
Required
✅
Incident Report Submitted
Your report has been received and forwarded to EOC Operations.
A copy has been filed in LOOMI.
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