Smoking/Vaping School Incident Report

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The Health Unit is a partner in maintaining safe and healthy schools in our community. This online School Incident Report form offers school staff a quick, convenient, and secure way to report violations of the Smoke-Free Ontario Act, 2017 that occur on school property. Incident Reports will be directed to our enforcement team at the Heath Unit, and will be followed-up by an enforcement officer.

School Name * Required
Sender's Name * Required
First Last
Phone * Required
Email
Date of Offence * Required
DD slash MM slash YYYY
Time of Offence * Required

Hours :

Minutes

AM/PM AM/PM
Offence * Required
- SFOA 12(1) Smoking Tobacco, Vapour Products, or Cannabis Offences
- SFOA 3(1) Supplying or Selling Tobacco or Vapour Products Offences
- SFOA (Other)
Witness Name * Required
First Last
Number of Students Involved * Required
List of Students Involved * Required
Student Initials Under 16 16 or Older
Brief Description of Incident
(use only initials, no full names)
At our meeting we will need to collect the following:
- A witness statement
- Student(s) names
- Student(s) date of birth
- Student(s) address
- Parent(s) or legal guardian(s) contact information
CAPTCHA

Student Initials	Under 16	16 or Older

At our meeting we will need to collect the following: