NEW ALBANY POLICE DEPARTMENT - New Albany, Ohio

Addendum C
Officer - Subject Factors (Check all that apply)
Age Sex Size Skill level Multiple suspects/officers Relative strengths
Special Circumstances (Check all that apply)
Closeness of a weapon Injury or exhaustion Being on the ground
Distance from subject Special knowledge/previous contact
Reason Force had to be used
To effect arrest To protect another To prevent a violent forcible felony
To restrain suspect for his/her safety
To defend the reporting officer
Other:
Witnesses (Including Backup Officers):
Name: (Last, First, MI) Address or Department Name: Phone Number:
Was Suspect Injured or Claims of Injury?
Yes No
If injured or claims or injury, list nature of injuries or claims of injuries:
Was Suspect treated for Injuries?
Yes No
If no, list reasons why:
Was Suspect Transported to Hospital?
Yes No Admitted
Hospital:
Transported by:
Attending
physician:
Arrested For:
PD-99-209
Revised February 2012
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