I. Critical Incident Reporting Form
II. Critical Incident Reporting Protocol
Effective May 1, 2018
The Behavioral Health Services Division has implemented a new Critical Incident Reporting Form (CIR Form) and Critical Incident Reporting Protocol (CIR Protocol) to provide guidance for reporting critical events experienced by behavioral health service recipients.
All providers are required to report critical incidents, however only Sentinel Events are reported directly to the Human Services Department - Behavioral Health Services Division (BHSD). Refer to the Critical Incident Reporting Protocol (2018) for additional information and reporting resources.
The new CIR Form template and its accompanying CIR Protocol will be available on the following website:
. This template features drop-down menu options, and can be filled out, saved, and sent without printing.
This process does not supplant any reporting requirements that are mandated by another licensing agency such as Children Youth and Families Division (CYFD) or Aging and Long-Term Services Department (ALTSD) or Department of Health (DOH).
Questions regarding this supplement should be directed to the Behavioral Health Services Quality Team at 505-476-9266 or by email to: