The Marine Safety Group "Protecting Coastal Wildlife and People"
In This Site
Incident Report Form
Use this form to report injuries observed or received during an "INTERACTIVE MARINE EXPERIENCE" (i.e. shark dive, fish feeding dive, etc.) The Marine Safety Group will use this information to help further our efforts to ban the feeding of marine life by commercial dive operators. This information will not be used for any other purpose. Your name or personal information will not be released without your express written permission
*Name:
Address:
City:
State:
Zip:
*Email:
Phone:
This injury occurred:
During a feeding dive
Near a feeding site.
The injured party was swimming from:
The Beach
Private Boat
Commercial Dive Boat
*Location of incident:
*Date of incident:
*Describe what happened and the injury you observed or sustained:
