Incident Reporting

You must report any and all special incidents to your CCS or the on-call phone number if after hours. The Incident Reporting Form is below. 

DSP Incident Reporting Form 

If a medication error is made, you will need to complete a Medication Incident Report. Please also call Poison Control and notify Kodie Friend and/or the On Call Support by using the contact information below. If the person served begins to have any kind of reaction or experiences new symptoms after the error is made call 911. 

Poison Control: 800-222-1222

Kodie Friend : 479-222-8231 | kfriend@kistlercenter.org

On Call Support | 479-785-4677

DSP Medication Incident Reporting Form