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TXSNOW Incident Report — Instructor
TXSNOW Incident Report — Instructor
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事故发生日期和时间：
*
Date
Time
Resort：
*
Difficulty：
*
--- Select an option ---
Green
Blue
Black
Minutes into the Lesson when the incident occurred:
*
minutes
Run/trail name:：
*
Location on the run:
*
--- Select an option ---
Top
Mid-slope
Base
Lesson Information
Discipline：
*
--- Select a discipline ---
Snowboard
Ski
Shift type:
*
--- Select an option ---
On duty
Off duty / bystander
Lesson Type：
*
--- Select an option ---
1:1
2:4
Snow Buddies
Kids Master
Other
Are you responsible for multiple participants at the same time?
*
--- Select an option ---
No
是（请在“其他学员安置”中说明）
Other：
*
Incident category
Severity：
*
--- Select an option ---
Minor (no patrol involvement)
Moderate (patrol involved)
Major (requires medical attention / lesson terminated)
Type (select all that apply):
Fall
Collision (person-person)
Collision (person-object)
Lost/Separated
Equipment malfunction
Weather/Visibility
Medical
Behaviour/Discipline
Other
Other ：
*
Environment & Conditions
Weather/Visibility：
*
Snow surface conditions：
*
Crowd density：
*
--- Select an option ---
Low
Medium
High
Equipment Check：
*
--- Select an option ---
Pre-lesson
Mid-lesson
High
Temp/Wind：
*
Identified issue：
*
Please describe
Lesson content immediately before the incident
Action/activity immediately before the incident:
*
e.g., demonstrating a turn / straight run / stationary stop / loading the lift / unloading the lift; perceived slope steepness / speed
Please describe the sequence of events objectively and in chronological order:
*
Include commands given, regroup points, visibility management, and spacing control
Instructor injury and immediate response
Primary injury location:：
*
Actions taken:：
*
Alert / warming / stabilization / bleeding control / load reduction
Impact on ability to work:
*
--- Select an option ---
No (no loss of teaching time)
Yes
Leave requested:
*
hours / days
Expected return-to-work date:
*
External communications
Ski Patrol：
*
--- Select an option ---
No
Yes
Arrival time：
*
Witness name：
*
Case number:
*
Witness contact information：
*
Was medical transport / emergency care required?
*
--- Select an option ---
No
Yes
Hospital / method:：
*
Other participant arrangements (if responsible for multiple participants at the time)
Arrangement method:
*
Relay accompaniment / wait at nearest regroup point / transfer to an equivalent-level Instructor / dismiss
Communication record:：
*
With participant / parent / on-duty coordinator
Evidence & Privacy
Privacy statement: This report is used solely for safety and compliance purposes and is handled in accordance with PIPEDA’s data-minimization principles.
Upload on-site photos/videos:
*
Drag & Drop Files,
Choose Files to Upload
You can upload up to 50 files.
Environment, safety perimeter, and equipment position only; avoid exposed bodies or facial close-ups.
Signature and confirmation
Instructor name：
*
Phone number:
*
Signature
*
Clear Signature
Instructor ID：
*
Email
*
Date：
*
submit form
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