Report an accessibility issue.
Connecticut’s Official State Website Logo State of Connecticut
×
 
Close Search
  • Arabic
  • Chinese (Simplified)
  • Chinese (Traditional)
  • English
  • French
  • German
  • Haitian Creole
  • Hindi
  • Italian
  • Korean
  • Pashto
  • Polish
  • Portuguese (Brazil)
  • Russian
  • Spanish
  • Filipino
  • Ukrainian
  • Vietnamese
Connecticut Developmental Services
C Logo
Connecticut Developmental Services
  • Facebook
  • Instagram
  • X
  • YouTube
Connecticut Developmental Services
☰ Connecticut Developmental Services Main Menu
× Close
⮐ Back
⮐ Back
  • Home
  • Individuals & Families
    • Assistive Technology
    • Charting Lifecourse
    • Self Determination
    • Self Advocacy
    • Find a Provider
    • Guardianship
  • Supports & Services
    • Access to Supports
    • Case Management
    • Family Supports
    • Transportation
    • Community Living
    • Employment & Day Services
    • Health Services
    • Self Direction
    • Children's Services Division
  • Eligibility
    • How to Apply for Services
    • Individuals with intellectual disability
    • Autism
    • Birth to Three
    • Reassessment
    • Hearings Decisions
  • News & Updates
    • Commissioner's Corner
    • Calendar
    • Fourth Tuesday Forums
    • Subscribe to Newsletter
  • Provider Gateway
    • Provider Communications
    • Health & Dental
    • Resources for Providers
    • CCH Licensee Training
  • About
    • Boards & Councils
    • DDS Commissioner
    • DDS Regions
    • DDS Mission
    • Ombudsperson
  • Contact
    • Help line
    • Report Abuse & Neglect

You are about to Logout

Are you sure you want to log out of your account? If you do want to logout, please click "Logout".
Logout
  • CT.gov Home
  • DDS
  • Current: Incident Report Forms
  • Families
  • Provider Gateway
  • Boards & Councils
  • Divisions
  • Regions
  • Topics A - Z
  • Programs and Services
  • Advocates' Corner
  • STEP
  • Subscribe for DDS Updates
Search Department of Developmental Services
Filtered Topic Search

Incident Report Forms

DDS Incident Report Follow-up Form (regular) (PDF)

DDS Incident Report Form 255 OH/Fam (DOC)
DDS Incident Report Form 255 OH/Fam (PDF)

DDS Medication Error Report Form 255M (DOC, KB)

DDS Electronic Incident Report Form Instructions(PDF, 78 KB)
Connecticut Developmental Services
Facebook external link Instagram external link X external link YouTube external link

460 Capitol Avenue
Hartford Connecticut 06106


Individuals & Families
  • Assistive Technology
  • Charting Lifecourse
  • Self Determination
  • Self Advocacy
  • Find a Provider
  • Guardianship

Supports & Services
  • Access to Supports
  • Case Management
  • Family Supports
  • Transportation
  • Community Living Services
  • Employment and Day Services
  • Health Services
  • Self Direction

Eligibility
  • How to Apply for Services
  • Individuals with intellectual disability
  • Autism
  • Birth to Three
  • Reassessment
  • Hearings Decisions

Step

News & Updates
  • Commissioner's Corner
  • Calendar
  • DDS Updates
  • Fourth Tuesday Forums
  • Subscribe to Newsletter

Provider Gateway
  • Provider Communications
  • Health & Dental
  • Resources for Providers

About
  • Boards & Councils
  • DDS Commissioner
  • DDS Regions
  • DDS Mission
  • Ombudsperson

Contact
  • Help line
  • Report Abuse & Neglect
ct.gov logo with flag embelishment
  • About CT
  • Policies
  • Accessibility
  • Directories
  • Social Media
  • For State Employees
US Flag Status icon
United States
Mast: (Full)
CT Flag Status icon
Connecticut
Mast: (Full)

© 2026 CT.gov - Connecticut's Official State Website