DAN: Incident Report
INCIDENT REPORT (Breath Hold)
Intro Step 1
Incident
 Step 2
Victim
 Step 3
Lifestyle
 Step 4
Experience
 Step 5
Trip
 Step 6
Details
 Step 7
Additional Info
INCIDENT REPORT
ABOUT
Divers Alert Network (DAN) has maintained a diving incident database since 1989. Originally it was limited to scuba diving incidents. This on-line reporting system is designed to include breath-hold diving incidents. In addition, rebreather incidents will now be reported separately from scuba incidents.
INSTRUCTIONS
Persons reporting cases are not required to provide their name and contact information. The information is requested to facilitate follow up if warranted (and if the person grants permission for contact to be made - asked as one of the final questions). The results of our data collection and analyses are made public for the benefit of the community. Data are released only in anonymous form. No individual shall be identified in the reviews of cases presented verbally or published.

We appreciate your time and effort in providing this information. The incident collection instrument is divided into eight steps/tabs each with a series of questions. The time required to complete the forms will vary with the amount of detail available and the complexity of the case. Hidden fields will appear if responses prompt the need. Each tab will be saved automatically when you select "Submit and Continue." After saving a tab, you will automatically be moved to the next one. You will be able to move forward and backward through saved tabs to make any necessary changes until you select "Done - Submit Incident Report" on the final tab. At that time, you will no longer be able to return to the case.

Please let us know if you have questions or problems concerning this process.
GETTING STARTED
First Name:
Last Name:
Email:
Phone:
Incident:
Measurements:
Dive Mode:
©2014 Divers Alert Network