Calamity notification Wmo municipality of Tytsjerksteradiel

Progress

33%

Your report

Please indicate below (anonymously if necessary) what you would like to report and what your concerns are. You can type your text in the field and/or attach it via an attachment. In any case, make sure the following is clearly described in your report:

- Who is involved (both provider/caregiver involved)
- details about the client involved (name, date of birth, gender, place of residence)
- where did the calamity take place?
- description of the report: what happened?
- anything else you wish to report about this.

After your report, we will contact you by phone within 2 business days to discuss the report further.

The information known to you about the provider and caregivers involved

Information about the client(s) involved such as name, possible date of birth, gender, place of residence

Data on the municipality involved in the emergency (location of event, location of provider, location of person involved)

Details of the content of the emergency: describe your report as comprehensively as possible

What do you know about the current safety of the client and any others?

Have other stakeholders already been informed of the notification you are hereby making? If so, who are informed?

What is your assessment of the consequences: could this lead to social unrest and/or media attention?

Do you have any other additions or comments? If so, please list them here.

Appendix

Choose file(s)

Your data

Initial(s)

Surname

Phone number

The phone number must begin with 0 and consist of 10 digits. Only digits may be entered in this field.

Email address