Gaming Incident Report Form

Documents incidents on the gaming floor, including disputes, irregularities, and player issues, with a clear audit trail for follow-up and review.

Submission Notice

• Reporter Name
  Optional unless your site requires identification for follow-up.
• Reporter Role
• Reporter Contact Information
  Optional contact detail for follow-up. Avoid collecting unnecessary PII.
• Submission Type
  Choose whether the report should identify the reporter or remain confidential.

Incident Overview

• Date of Incident
• Time of Incident
• Location on Gaming Floor
• Incident Category
• Brief Summary of Incident
  Provide a concise factual summary of the incident.

People Involved

• Was a player or guest involved?
• Player Identifier
  Use a player card number, ticket number, or other internal identifier if available. Do not collect full DOB or SSN.
• Number of Other Parties Involved
  Enter the count of additional people involved.
• Were witnesses present?
• Witness Names or IDs
  List only the names or internal IDs needed for follow-up.

Incident Details

• Type of Dispute
  Select all that apply.
• Type of Irregularity
  Select all that apply.
• Type of Player Issue
  Select all that apply.
• Equipment Issue Type
  Select all that apply.
• Detailed Description
  Describe what happened, including observable facts, sequence of events, and any statements made.
• Immediate Action Taken
  Select all actions taken at the time of the incident.

Impact and Escalation

• Operational Impact
• Estimated Financial Impact
  Enter an estimated amount only if known and relevant.
• Was there any injury or medical concern?
• Injury or Medical Details
  Provide only the minimum necessary details for safety follow-up.
• Escalation Required
• Escalation Team

Attachments and Follow-Up

• Supporting Attachments
  Upload photos, screenshots, or short video clips relevant to the incident.
• Follow-Up Owner
• Follow-Up Due Date
• Additional Notes
  Include any extra facts needed for review, investigation, or closure.