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How do I fill this out?
To fill out the Wingman Intervention Submission Form, start by gathering all relevant information regarding the intervention. Ensure to provide anonymous details about the individual at risk, while capturing your relationship with them. Carefully describe the behavior identified and the action you took to intervene.
How to fill out the Wingman Intervention Submission Form?
1
Gather pertinent information for the intervention.
2
Complete personal details for the individual submitting.
3
Describe the at-risk behavior observed.
4
Document the actions taken during the intervention.
5
Include the outcome of your intervention efforts.
Who needs the Wingman Intervention Submission Form?
1
Military personnel needing to report interventions.
2
Supervisors responsible for interventions in the workplace.
3
Family members recognizing at-risk behaviors.
4
Friends wanting to help their peers in need.
5
Bystanders observing concerning behaviors in their surroundings.
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What are the instructions for submitting this form?
To submit this form, return the completed document to your local Violence Prevention Integrator via email or physical mail. Ensure to include any contact information needed for follow-up. Be mindful of deadlines set by your unit for reporting such interventions to ensure prompt handling.
What are the important dates for this form in 2024 and 2025?
Please check with your local guidance for applicable training and intervention programs in 2024 and 2025.
What is the purpose of this form?
The purpose of the Wingman Intervention Submission Form is to facilitate the identification and reporting of potential at-risk behaviors in various contexts. It aims to empower individuals to act when they recognize concerning behaviors in their peers, friends, or family members. By documenting interventions, this form plays a crucial role in promoting safety and wellness in the community.
Tell me about this form and its components and fields line-by-line.
- 1. Unit: The military unit of the individual reporting.
- 2. Name/Grade of individual who intervened: Name and rank of the person making the intervention.
- 3. Contact info: Contact details including phone and email.
- 4. Date of intervention: The month and year when the intervention occurred.
- 5. Duty status: Indicates whether the individual was on or off duty.
- 6. Personnel category: Specifies if the at-risk individual is military, civilian, or contractor.
- 7. Relationship to at-risk individual: Describes how the individual intervening relates to the person at risk.
- 8. Potential at-risk behavior identified: Details the concerning behavior observed.
- 9. Action taken: Describes the actions taken to deter the at-risk behavior.
- 10. Outcome: Documents the result of the intervention.
- 11. Resources utilized: Helps identify any resources or agencies that helped in the intervention.
- 12. Wingman release: Indicates agreement to release personal information.
What happens if I fail to submit this form?
Failing to submit this form may result in a lack of recognition and support for at-risk individuals. Proper intervention may be delayed, putting individuals at higher risk. It is crucial to document the intervention promptly to ensure timely assistance and action.
- Delayed Support: Individuals at risk might not receive timely intervention.
- Lack of Accountability: Failure to document can lead to insufficient action on observed risks.
- Missed Opportunities for Help: Without intervention reports, resources may not be allocated effectively.
- Impact on Community Welfare: Unreported interventions can contribute to ongoing issues within the community.
How do I know when to use this form?
- 1. Observing Unsafe Behaviors: Use this form when you notice someone engaging in dangerous activities.
- 2. Identifying Mental Health Signs: When you observe individuals showing signs of distress or potential self-harm.
- 3. Intra-Workplace Concerns: Report behavior that impacts the safety and effectiveness of the workplace.
- 4. Caring for Friends or Family: Utilize the form to help someone within your personal relationships.
Frequently Asked Questions
What type of information can I input on this form?
You can provide details about at-risk behaviors, actions taken, and outcomes related to the intervention.
Is my information kept confidential?
Yes, the form emphasizes anonymity for individuals who intervene.
What should I do if I witness concerning behavior?
Fill out the form to report the observed behavior and your intervention.
Can I edit the form after downloading?
Yes, you can edit the PDF as needed before submitting.
Is there a deadline for submitting this form?
Specific deadlines may apply; please refer to your organization for details.
Where can I submit the completed form?
Completed forms should be sent to your local Violence Prevention Integrator.
Can I save the PDF after editing?
Yes, you can download the edited PDF to your device.
How do I access the sharing options?
Sharing options are available after editing your PDF.
What if I need help filling out the form?
Feel free to reach out to your organization's support for guidance.
Is there a mobile version of this tool?
Yes, PrintFriendly is accessible from mobile devices for on-the-go editing and sharing.
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