OREGON ELAW

  • 4.06 USE OF FORCE REPORT FORM





    Gresham Police Department




    □ 01 Defend self □ 03 Make arrest □ 05 Civil hold □ 07 Other _________________________________
    □ 02 Defend another □ 04 Prevent escape □ 06 Accomplish official purpose (explain)_________________________
    __________________________________________________________________________________________________
    Warning Given Before Deployment: □ YES □ NO □ Not feasible
    □ 01 Pressure points □ 03 Takedowns □ 05 Not applicable
    □ 02 Control holds □ 04 Hobble EFFECTIVE? □ YES □ NO
    □ 01 Hands/Feet □ 03 Flashlight □ 05 Other __________________________
     □ 02 Baton □ 04 Not applicable EFFECTIVE? □ YES □ NO
    Distance (Feet) □ 01 1-3’ □ 02 4-7’ □ 03 7+ □ 04 Not applicable
    Duration (Seconds) 1    st _________ 2nd _________ 3rd _________ EFFECTIVE? □ YES □ NO

    Impact Munitions

    Type/Distance
    Officer □ YES □ NO

    Suspect □ YES □ NO

    □ 01 Bean bag _______Feet □ 04 Other ________Feet
    □ 02 Stingers _______Feet __________________________
    □ 03 Sage _______Feet

    □ YES □ NO If not, why?
    □ 01 Clothing □ 04 No physical effect
    □ 02 Missed □ 05 Other____________
    □ 03 Malfunction ____________________


    USE OF FORCE REPORT



    PAGE 1 OF 2

    Case No.

    		Refer Case No.
    		Classification
    		Date/Time Reported


    		Date/Time Occurred
    		Location of Occurrence
    		Suspect Name
    		Sex
    		Race
    		Hgt
    		Wgt
    		DOB
    Remarks

    Use of Force / Control Necessary to:


    		Physical Control: Impact Weapons: Pepper Spray:


    		CHECKED BY MEDICAL


    		EFFECTIVE?
    Rounds Fired______________ Hits____________

    Where Impacted_____________________________________________________

    		Reporting Officer DPSST
    		Div
    		Shift
    		District
    		Supervisor’s Signature




    GRESHAM POLICE DEPARTMENT



     Taser □ Not applicable

    □ 01 Probe
    □ 02 Drive stun
    □ 03 Laser only

    □ 1 □ 4
    □ 2 □ 5
    □ 3 □ OTHER________________

    □ 01 0-5’ □ 03 11-15’
    □ 02 6-10’ □ 04 16-21”

    Did Probes Penetrate the Skin? □ YES □ NO
    □ YES □ NO If not, why ?
    □ 01 Heavy clothing □ 04 Malfunction □ 07 Other __________________________________________
    □ 02 Subject moved □ 05 One probe ____________________________________________________
    □ 03 Missed _____________________________________________________

    Taser Serial #________________________ Cartridge #___________________________


    Officer Suspect
    □ 01 None □
    □ 02 Bruises □
    □ 03 Abrasions □
    □ 04 Lacerations □
    □ 05 Broken bones □
    □ 06 Other
    ________________________________


    Officer     □ YES □ NO
    Suspect     □ YES □ NO


    Officer     □ YES □ NO ____________
    Suspect     □ YES □ NO ___________


    Case No.

    USE OF FORCE REPORT


    PAGE 2 OF 2


    Application

    Cycles

    Distance (Feet)


    		EFFECTIVE?



    		Injuries

    Checked by Medical

    		Taken to Hospital Where
    		 A = Drive Stun C = Munitions E = Impact Weapons
    B = Probes D = Pepper Spray

    Name/DPSST

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