VARR Incident Reporting

It is the policy of the Virginia Association of Recovery Residences (VARR), that all accredited residences, members, and organizations report all major incidents. A major incident is defined as any emergency or situation that has significant impact for urgency which demands a response beyond routine incident management. A major incident also includes but is not limited to any volunteer, staff, and owner of an organization that violates the signed code of ethics and or whose actions either directly or indirectly affect a participant or resident of the organization. If a major incident occurs it is the responsibility of the VARR accredited organization to report the major incident on the approved VARR Incident form and submit it with a written summary of the incident within 5 days from the date of the incident. The incident form and summary of the incident will be sent to the VARR office; VARR will review the incident report. When deemed necessary, VARR may send the incident report to the Board of Directors and/or a special committee for further review. VARR will keep record of all major incidents and keep a file of each major incident report. 

File an Incident Report

Certified recovery residence providers should use the form below to submit an incident report.

Section 1 - Identifying Information

Please enter the name of your organization.
Please enter the name of organization's representative submitting the incident report.
Please enter reporting part name's email address
Was emergency services called?(Required)
Was 911 called and did police, fire, EMS, etc. respond.

Section 2 - Type of Incident

Check the box that most appropriately describes the incident

If Other, please desribe.

Section 3 - Level of Severity

Please select the Level of Severity below
Level of Severity

Section 4 - Individuals Involved

Please list the Names (first & last) of all individuals involved, and whether or not they were a participant in the incident or witness of the incident.
Select One
Select One
Select One
Select One

Section 5 - Description of Incident

Please give a detailed account of the incident - (Who, What, When, Where, Why, How)

Section 6 - Investigation & Follow-Up

Please describe in detail any findings from the incident and recommendations and actions to the incident. Also, if applicable please describe any lessons learned and future solutions to better prevent and/or respond to the type of incident.
If applicable please describe any lessons learned and future solutions to better prevent and/or respond to the type of incident.
Max. file size: 2 GB.
If there is any additional documentation you need to submit, please upload here.