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# DLA Official Forms

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| Form Number:  DLA1845                                                                                                                               |
|-----------------------------------------------------------------------------------------------------------------------------------------------------|
| Form Title:  DLA Child and Youth Program (CYP) Occurrence Incident/Injury Report                                                                    |
| Form Version:  Feb 2018                                                                                                                             |
| Status:  Active                                                                                                                                     |
| Functional Area:  Installation Management                                                                                                           |
| Opr:  DM                                                                                                                                            |
| Safeguards:  PAS, PII                                                                                                                               |
| Electronic:  Yes                                                                                                                                    |
| Form Link:  Documents/FormsSite/forms/DL1845.pdf                                                                                                    |
| Type:  Primary                                                                                                                                      |
| Prescribed:  DLAI 1015.02                                                                                                                           |
| Description:  This form is used to report and document all injuries/usual occurrences sustained by a child in the DLA Child and Youth Program.      |
| Records Retention:  7304.1.02 Child Development Center. upon termination from the program forward records to Child Development Services Coordinator |
| Form Audience:                                                                                                                                      |

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