"Ouch Report"
Unitarian Universalist Congregation of Erewhon
Use this form whenever you give first aid to a legal minor in your group -- even if all you did was put on a band-aid.
Age group: ________________ Date and Time: _______________
Your name: ________________ Your co-teacher: _______________
Name of child to whom you gave first aid: ________________
What first aid did you have to give?
What incident happened that the child needed first aid? Please describe the incident briefly.
Who witnessed this incident?
____ Check here if you observed Universal Health Precautions.
____ Check here if you had to call 911.
____ Check here if you notified the parents/guardians by giving them a copy of this form.
Thank you for handling this incident!
____________ Date read by Director/Minister of Religious Education