Michigan Public Employees SEIU Local 526m

Report a Critical Incident

Please complete this form with as much information as possible. We will get back with you via phone or e-mail if clarification is needed.

e-mail*

First Name*

Middle Name

Last Name*

Facility*

Today's Date*

Date of Incident

Location in Facility

# of staff involved

# of inmates involved

# of staff injured

If a weapon, what type?

Description of Incident:

Management's response and any problems with it:

Suggestions for how this could have been prevented:

Word or Number Verification*

Type the words or numbers you see below into the Word Verification box.

CAPTCHA Word Verification

Instructions

Please enter the characters you see in the box, in order and separated by a space. This helps prevent automated programs from abusing this service.

If you are not sure what the words or numbers are, either enter your best guess or click the reload button next to the distorted words.

Visually impaired users can click the audio button to hear a set of digits that can be entered instead of the visual challenge.

* denotes required field

© Michigan Corrections Organization
421 W. Kalamazoo St., Lansing, MI 48933 | 517-485-3310 toll-free: 800-451-4878
Service Employees International Union, CTW, CLC
Contact | Privacy Policy