Report a Save

Submitted by dclewis1 on

In an effort to document and record SAVES in North Carolina, we are asking you to submit information about any SAVE that takes place or has taken place in your community. By SAVE, we are referring to an event where someone was not injured or killed due to the positive impact of your Community Risk Reduction (CRR) program. This information will be used to illustrate the success of CRR programs and to use as a tool to encourage more Chiefs, Directors, Supervisors, etc. to become involved in effective CRR programs. Please take a few minutes to complete the form below.

Indicates required field
Incident Information
Services Provided (Select all that apply)
(Please write a brief summary of the incident details, telling us exactly what happened leading up to and during the event. Provide as much detail as you can including person’s involved, Educators involved, Chief/Directors involved and any other important information that may be useful.)
Form Submitted By
SAVE Award Recipient Information
Chief/Director Information

Attachments:

Please submit any newspaper articles or pictures of the event, safety device, child, fire department, agency, etc that is public information to Lisa.Blackmon@ncdoi.gov or print and mail completed form, pictures, articles, etc. to:

Lisa Blackmon
1202 Mail Service Center
Raleigh, NC 27699-1202

 

Please contact Lisa.Blackmon@ncdoi.gov if you need help with this form.

This question is for testing whether or not you are a human