# Incident report form

> For reference purposes only. Not legal advice. Draft for review by a qualified professional.

> How to use this template. The fields recorded for each AI incident. Replace every [placeholder], delete guidance notes and have a qualified professional review the result. Template version 1.0, last reviewed 2026-10-03. Certainty: simplified.

## Identification

Incident ID, system, date found, reporter.

[Enter your text here]

## Description

What happened, in plain words.

[Enter your text here]

## Severity and people affected

S1 to S4, number and groups affected, regions.

[Enter your text here]

## Actions and notifications

Containment, fixes, who was told and when.

[Enter your text here]

## Cause and lessons

Root cause and changes made.

[Enter your text here]

## Certainty notes

- Simplified: a general starting point. Rules differ by region.

> For reference purposes only. This site offers general guidance for learning and planning; it is not legal advice and creates no lawyer-client relationship. Rules change often, so check the primary sources and qualified counsel before you act.