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Incident Reporting

Web Enabled Incident Reporting System (WEIRS)

Web Enabled Incident Reporting System (WEIRS)

An on-line incident reporting system for utilization by community mental health and drug and alcohol providers, MH residential facilities, adult care facilities, and private psychiatric hospital providers to report both INCIDENTS, and Six Month Reportable Data.

In order to access the system, you will need to select one person from your organization to serve as the “external administrator”, which is the individual who is authorized to assign User Roles (level of access privileges) to other staff.  The External Administrator may register up to eight certification or license numbers for one account.  Please note that the system is not yet available for reporting AoD incidents. 

Reportable Incident Forms:

Adult Care Facilities (Family/Group Home), and Adult Foster Homes Reportable Incent Form
DMHAS - 7072

Community Mental Health and Alcohol and Other Drug Provider Notification of Incident Form:
DMHAS-0484

Licensed Residential Mental Health Provider Reportable Incident Form:
DMHAS-0484a

Private Psychiatric Hospital Reporting Form
DMHAS-0177

Licensed residential and certified community agencies must track critical care incidents related to health and safety within their facilities. Incident notification reports may be submitted in one of the following three ways:

Email:

IncidentReport@mha.ohio.gov

Fax:

(614) 485-9737

Mail:

OhioMHAS
30 East Broad Street – 7th Floor
Columbus, Ohio 43215

Certified Community Providers (MH and AoD)

Licensed Residential Providers

Instructions for Six Month Reportable Incident Data Report Form

The Web Enabled Incident Reporting System (WEIRS) can be utilized for reporting the Six Month Reportable Data.

Community Mental Health and/or Addiction Services Provider
Type 1 Residential Facility
Inpatient Psychiatric Service Providers

 

If Submitting by Email

  1. Save blank form
  2. Fill in and complete the report form
  3. Save file under a new name
  4. Attach to email address shown on Page 1 of the report form

If Submitting by Fax

  1. Save blank form
  2. Fill in and complete the report form
  3. Save file under a new name
  4. Send to fax number shown on Page 1 of the report form
Report a Complaint

If you wish to submit a complaint concerning a licensed or certified Ohio Department of Mental Health and Addiction Services provider, please complete all applicable fields on the form below and submit. We will respond to all complaints. Thank you.
Complaint Form DMH-LIC-0982 (PDF)