FACTUAL WORK EVENT — ORIGINAL PREPARATION CARD
Event date/time and uncertainty:
Setting and permitted task reference:
What happened; exact record or recollection:
Direct observation / recollection / second-hand / inference:
Existing evidence and authorized location:
Witness and the particular part they may have observed:
Work impact and personal impact in my own words:
Actual policy/version and appropriate recipient:
Alternative route if that recipient is involved:
Specific response requested:
Handling/confidentiality question still unanswered:
Sent date/version; receipt; next procedural contact:
Correction or new information/date:
No witness, perfect file or website score is required before raising a needed concern.