                                        Ministry of the Solicitor General                              Use of Force Report
                                                                                                       Police Services Act


Fields marked with an asterisk (*) are mandatory. Select more than one box in each section, where appropriate.

Select Police Service* (select only one)

    Municipal Police Service                ► Division/District/Other (Appendix A)

    Ontario Provincial Police               ► Detachment (Appendix B)

    Other Agency                            ► Specify

Part A
Date (yyyy/mm/dd) *                   Approximate Time Force was Applied (24 hour) *                       Incident/Occurrence Number *


Location of Incident * (select only one - provide the most precise location information available for the incident)
    GPS Coordinates Specify                                                             Postal Code Specify

    Address Specify

    Closest Intersection Specify                                                        Other Specify

Location Type * (select all that apply)
    Residential Building                 Non-residential Building           Motor Vehicle                  Open Space             Public Transportation

Report Type *
    Individual ► Total years of service as a police officer                       Rank category (select one) (Appendix C)

                                                                                              How many officers were part of the team
    Team ► Type of Team (select one) (Appendix D)
                                                                                              response, Including yourself?

Type of Assignment *
              Non-                             Assignment Type (select one) (Appendix E)                Type of Incident * (select one) (Appendix F)
Attire:                          Uniform
              Uniform
Persons Present at Time Force Applied *
Total number of subjects on whom you used reportable force?                        Specify #

    No interaction with subject                 None (animal only)

Approximately how many other officers were engaged with the subject at the time you applied force? Specify

Subject 1 *
What race category best describes this individual? (select only one)

    Black           East / Southeast Asian               Indigenous           Latino                 Middle Eastern           South Asian       White

Did you have any difficulties perceiving the race of the subject?                       Yes Specify                                                  No

What age category best describes this individual? (select only one)

    Under 12               12-17                18-24         25-34             35-44                 45-54           55-64           65 and older

What gender category best describes this individual? (select only one)                         Male             Female           Trans/non-binary/other

Distance between you and the subject (at the time decision was made to use force)

    Less than 3 metres (approx. 10 feet)                 3 to 7 metres (approx. 10 to 23 feet)                Greater than 7 metres (more than 23 feet)

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Reason(s) for use of force (select all that apply)
    Effect arrest         Prevent an offence          Prevent escape            Protect other officer(s)         Protect public (including victims)

    Protect self          Protect subject(s)         Unintentional          Other Specify

Identify the information/factors that influenced your response (select all that apply)
Subject actions:          Resistant Passive             Resistant Active              Assaultive           Serious Bodily Harm or Death

    Nature of the call          Past history with subject           Physical size, strength, abilities         Other factors (e.g. CPIC, dispatch)

Subject perceived to have access to a weapon(s) (select all that apply)

    Aerosol              Canine                Club or impact weapon                  Handgun              Long gun (rifle, shotgun)

    Knife/Edged                Vehicle             Unknown type of weapon                    Other Specify

Location of weapon(s) (select all that apply)

    Accessible (e.g. within reach)                   In hand               On person, including concealed

Officer Response
Did you issue directions to the subject to comply? *                Yes       No       If yes, did the subject comply?         Yes       No

Did you attempt/use de-escalation techniques? *                Yes         No

If yes, specify:        Communication                Containment                Cover               Distance             Repositioning

    Teamwork           Time       Other Specify                            If no, specify:       Imminent threat         Immediate action required

    De-escalation use/attempt by other officers             Other Specify

Did the de-escalation techniques assist in controlling the subject’s behaviour?                    Yes     No

Type of Force Used *
Physical Control (select all that apply)           Escort techniques                 Grounding             Joint Locks               Pinning

    Pressure Points                  Strikes                Other Specify

Did this assist in controlling the subject’s behaviour?              Yes        No

Intermediate Weapon (e.g., pepper spray, baton, CEW - check all that apply)

    OC (pepper spray)          Did this assist in controlling the subject’s behaviour?             Yes      No

    Baton           Hard (e.g. strikes)        Soft (e.g. prying)    Did this assist in controlling the subject’s behaviour?           Yes         No

    Conducted energy weapon (CEW)                     Drawn and Displayed with the intention of achieving compliance                      Pointed

    Discharged ►              Cartridge / probe                Drive / push stun                   3-point contact

Cycles                  Single cycle (5 seconds)            Extended cycle (more than 5 seconds)                     Multiple cycles

Did this assist in controlling the subject’s behaviour?             Yes       No

If CEW did not assist in controlling the subject’s behaviour, specify why (select all that apply)

    Cartridge Malfunction            Disconnect              Insufficient Probe Spread              Operator Error                Probe Miss

    Weapon Malfunction                    Other Specify

Less Lethal Firearm (select all that apply)

    Shotgun (e.g. bean bag round):              Pointed        Discharged

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Did this assist in controlling the subject’s behaviour?                 Yes      No

    Extended Range Impact Weapon:                    Pointed        Discharged

Did this assist in controlling the subject’s behaviour?                 Yes     No

    Other (e.g., canine, horse, weapon of opportunity)

Specify                                                           Did this assist in controlling the subject’s behaviour?     Yes        No

Firearm (select all that apply)

    Handgun               Drawn          Pointed           Discharged    Did this assist in controlling the subject’s behaviour?      Yes        No

    Rifle                                Pointed           Discharged    Did this assist in controlling the subject’s behaviour?      Yes        No

    Shotgun (Lethal)                     Pointed           Discharged    Did this assist in controlling the subject’s behaviour?      Yes        No

Did you issue the Police Challenge?                 Yes        No             Did the subject comply?       Yes       No

If did not issue challenge, specify:           Not viable           Issued by another officer           Other Specify

Person(s) Injured * Were physical injuries sustained because of the use of force applied?
Subject:            Yes           No               Fatal            Don’t Know (e.g., subject fled/escaped)

Officer:        Yes            No

Was treatment required? (select all that apply)

Subject:        No           First aid             Medical attention by personnel at scene            Admission to medical facility

    Medical attention at facility              Don’t Know                 Other Specify

Officer:        No           First aid         Medical attention by personnel at scene                Admission to medical facility

    Medical attention at facility              Don’t Know                 Other Specify

Narrative: (If no occurrence report) – Do not include personal names or information.




Part B
Date Report Submitted * (yyyy/mm/dd)                             Officer Involved (name, rank and badge number)


Reviewer 1:                                Last Name *                                       First Name *

                                           Badge Number *                                    Date (yyyy/mm/dd) *

Use of Force Training Analyst:             Last Name *                                       First Name *

                                           Badge Number *                                    Date (yyyy/mm/dd) *
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Appendix - List of Options

A. Municipal Police Service

- Aylmer PS                             - Hanover PS                          - Sault Ste. Marie PS
- Barrie PS                             - Kawartha Lakes PS                   - Smith Falls PS
- Belleville PS                         - Kingston PS                         - South Simcoe PS
- Brantford PS                          - La Salle PS                         - St. Thomas PS
- Brockville PS                         - London PS                           - Stratford PS
- Chatham-Kent PS                       - Niagara Regional PS                 - Strathroy-Caradoc PS
- Cobourg PS                            - North Bay PS                        - Thunder Bay PS
- Cornwall PS                           - Ottawa PS                           - Timmins PS
- Deep River PS                         - Owen Sound PS                       - Toronto PS
- Durham Regional PS                    - Peel Regional PS                    - Waterloo Regional PS
- Gananoque PS                          - Peterborough PS                     - West Grey PS
- Greater Sudbury PS                    - Port Hope PS                        - Windsor PS
- Guelph PS                             - Sarnia PS                           - Woodstock PS
- Halton Regional PS                    - Saugeen Shores PS                   - York Regional PS
- Hamilton PS

B. Ontario Provincial Police Region
- Central Region                        - East Region                         - General Headquarters
- Highway Safety Division               - North East Region                   - North West Region
- West Region

C. Rank category
- Commissioned officer                  - Non-commissioned officer            - Constable (1st to 4th class)/Special constable/Other

D. Type of Team
- Tactical Team                         - Apprehension Squad                  - Major Crime Unit
- Hostage Rescue Team                   - Canine Unit                         - Mobile Surveillance Unit
- Containment Team                      - Drug Enforcement Unit               - Public Order Unit
- Guns and Gangs Unit                   - Other Specify

E. Assignment Type
- Administrative (e.g., station duty)   - Drugs                               - Off duty
- Canine                                - Guns and Gangs, ROPE, other         - Patrol (e.g., general, foot, bicycle, ATV,
- Community liaison, school             specialized units                     snowmobile)
resource                                - Hostage rescue                      - Paid duty
- Community oriented/directed           - Investigations (CIB, Major Crime)   - Prisoner transportation/care/control
response                                - Marine                              - Public order
- Containment                           - Mental Health Response Unit/        - Tactical
- Court appearance                      Mobile Crisis Response Team           - Traffic
- Court security                        - Mounted                             - Other Specify

F. Incident
- Active Attacker                          - Family/neighbour/other type of dispute - Police custody related (e.g. prisoner
- Alarm                                    - Executing warrant (e.g., DNA, arrest, control, fingerprinting, lock-up area)
- Animal complaint                         search)                                    - Property crime
- Assisting other police service/agency    - Humane destruction of animal             - Public order
(e.g., EMS, animal welfare inspectors)     - Investigation (follow-up, ongoing)       - Stolen vehicle
- Barricaded subject                       - Other federal/provincial statutes (e.g., - Traffic (e.g., RIDE, vehicle collision)
- Disturbance (e.g., noise complaint,      LLA)                                       - Violent crime (non-IPV) (e.g., assault,
unknown trouble, unwanted person)          - Person in crisis (e.g., mental health,   car-jacking, robbery, homicide)
- Intimate partner violence (IPV)/         suicide threat)                            - Weapon(s)
dispute                                    - Person stop                              - Wellness/safety check


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