Adams School of Dentistry: Incident Report, Documentation, & Corrections



The purpose of the UNC Adams School of Dentistry (ASOD) Online Incident Form is to connect appropriate points of contact, maintain records of incidents that occur at UNC ASOD, while also automating the process to include instructions for next steps, notifying appropriate individuals or departments, and improving communication practices.


Use of the Online Incident Form is the responsibility of all ASOD personnel, including faculty, adjunct, staff, residents, students, and affiliates (i.e., interns, volunteers, and visiting scholars).

Online Incident Report Description

Online Incident Report ( is to be utilized whenever an incident or event occurs that may or may not have caused injuries to a person, damaged organizational assets, or impeded providing treatment. Some examples of this can include, but not limited to, adverse reactions to equipment or material, falls, burns, improper treatment, medical emergency, broken instrument, and swallowed object. Access to the Online Incident Report ( is unrestricted and can be completed from any mobile device, to ensure information and guidance is provided expediently.


Initial Submission

As soon as realistically possible, but no later than 24-hours after a reportable incident occurring, an ASOD personnel or their designee must submit an Online Incident Report (, to minimize response time. Once the form has been accessed, follow the guided steps and provide the necessary information which includes an email address, the incident type, location of the incident, and incident details. After the Online Incident Report ( is submitted, a confirmation email will be sent to both the reporting individual and the incident location point of contact, with an Incident ID number and a detail summary.

Post Submission

Depending on the incident type, additional actions may be required to receive the appropriate care. If this occurs, a follow up email will be sent to the reporting individual with, but not limited to, guidance on next steps, maps, additional forms, and/or an appropriate point of contact. Additionally, the appropriate UNC facility (i.e., Occupational Health [UEOHC], Campus Health, UNC Hospital Phlebotomy Lab, ASOD Human Resources, and/or ASOD Preceptor) is automatically notified, to provide additional assistance, if applicable.

Documentation & Corrections

If any documentation is generated (i.e., Medical Emergency Report) or corrections need to occur, send an email request to with the Incident Report ID (if known), date of incident, and what needs to occur. Modification and access to the master list is restricted, due to the sensitive nature of the content.

Related Requirements

External Regulations and Consequences

Unit Policies, Standards, or Procedures

Contact Information

Topic Title Contact
General questions Director of Clinical Compliance


Print Article


Article ID: 131273
Thu 4/8/21 9:05 PM
Tue 6/4/24 9:11 AM
Responsible Unit
School, Department, or other organizational unit issuing this document.
Adams School of Dentistry
Issuing Officer
Name of the document Issuing Officer. This is the individual whose organizational authority covers the policy scope and who is primarily responsible for the policy.
Issuing Officer Title
Title of the person who is primarily responsible for issuing this policy.
Director of Clinical Compliance
Next Review
Date on which the next document review is due.
06/04/2026 12:00 AM
Last Review
Date on which the most recent document review was completed.
06/04/2024 8:34 AM
Last Revised
Date on which the most recent changes to this document were approved.
05/09/2023 1:25 PM
Effective Date
If the date on which this document became/becomes enforceable differs from the Origination or Last Revision, this attribute reflects the date on which it is/was enforcable.
07/26/2021 12:00 AM
Date on which the original version of this document was first made official.
05/18/2020 12:13 PM

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Procedure for addressing swallowed objects during and outside regular hours, including instructions on clinical notes and updated processes.