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Incident Report Forms MUST be completed and submitted by FAX within 48 hours of the incident. Address the call and FAX to either your MATP Advisor or Program Manager. The MATP FAX Number is 717-705-8112.  \n\n|  |\n| --- |\n|  |\n|  |\n|  |\n|  |\n|  |\n|  |\n|  |\n|  |\n|  |\n|  |\n|  |\n|  |\n|  |\n|  |\n\nPRINT NAME OF PERSON SUBMITTING REPORT    \nSIGNATURE OF PERSON SUBMITTING REPORT    \nDATE OF REPORT   DATE FORWARDED TO DPW/OMAP/MATP    \n(PLEASE USE ADDITIONAL PAGES IF NEEDED )  \nNOTE: Immediately following the incident, notify the MATP Office by telephone. Incident Report Forms MUST be completed and submitted by FAX within 48 hours of the incident. Address the call and FAX to either your MATP Advisor or Program Manager. The MATP FAX Number is 717-705-8112.","cbCaivdjdk3cF19h","https://ap.wps.com/l/cbCaivdjdk3cF19h","pdf",13960,"English","# Incident details\n## Involved person information\n## Incident time, location, and injury/illness\n# Incident narrative and disposition\n## Description of incident\n## Final MATP disposition\n# Submission and signatures\n## Print name, signature, and report dates","[{\"question\":\"What information must be collected about the involved person?\",\"answer\":\"The form requests the involved person’s name, address, phone, age, and sex.\"},{\"question\":\"What details are required in the incident description?\",\"answer\":\"The description should include involved individuals’ names, the nature of the incident, witness names and addresses, and a narrative of what occurred. If illness or injury is involved, include the physician or hospital used.\"},{\"question\":\"When and how must the report be submitted?\",\"answer\":\"Immediately notify the MATP Office by telephone. 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