Problem Report Form
Filed by
Date
Who was involved?
Where did it happen?
When did it happen?
Did anyone else see what happened?
Who?
Tell what happened:
How do you feel about what happened?
How do you think the other person(s) feel(s) about what happened?
Why do you think the other person(s) feel(s) this way?
Name two ways you could have solved this problem:
What could you have done so it would not have happened at all?
Solution Report
Filed by
Date
The problem
My/our solution