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Incident Report · Pro

Retail Theft & Loss Prevention Incident Report Form

Capture every detail of in-store theft incidents—suspect descriptions, stolen merchandise, CCTV evidence, and witness contacts—all in one secure form.

Use This Template Free Preview

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formbuilder.ai/f/retail-store-theft-loss-prevention-incident-report-form

Retail Store Theft & Loss Prevention Incident Report Form

Incident Report Number

· · ·

Store / Branch Location

Department / Area of Store Where

· · ·

Submit

The Retail Store Theft & Loss Prevention Incident Report Form is a comprehensive tool designed to help retail managers, loss prevention officers, and store security teams document shoplifting, employee theft, and other inventory loss events quickly and accurately. It captures essential details including incident type, severity level, store location, department, and a full narrative of what occurred.

The form guides users through recording suspect descriptions, law enforcement involvement, police report numbers, and CCTV footage availability. It also includes a structured section for listing stolen, damaged, or missing items by SKU or description alongside an estimated loss value—giving your loss prevention team the data needed for investigations, insurance claims, and trend analysis.

Built for multi-location retailers, department stores, and boutiques alike, this template supports evidence uploads such as photos and surveillance screenshots, plus witness contact collection. By standardizing your incident documentation process, you reduce reporting errors, strengthen legal standing, and improve shrink prevention strategies across your entire organization.

3 Pages

24 Questions

~8min To complete

Free No credit card needed

Field types Short Text ×4 Long Text ×4 Dropdown ×3 Single Choice ×2 Date Time Picker Yes / No currency File Upload Phone Full Name Email Multiple Choice termsandconditions Signature

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Incident Overview 9 questions

Incident Details

1 Incident Report Number * Short Text

2 Store / Branch Location * Dropdown

3 Department / Area of Store Where Incident Occurred * Short Text

4 Date of Incident * Date

5 Time of Incident * Time Picker

6 Incident Type * Single Choice

7 Severity Level * Dropdown

8 Was Law Enforcement Contacted? * Yes / No

9 Police Report Number (if applicable) Short Text

Page 2 Incident Description & Evidence 8 questions

Incident Narrative & Supporting Evidence

1 Detailed Description of the Incident (who, what, when, where, how) * Long Text

2 Description of Suspect(s) — Appearance, Clothing, Distinguishing Features Long Text

3 Was the Incident Captured on CCTV / Surveillance? * Single Choice

4 Estimated Value of Loss or Stolen Merchandise * currency

5 List of Items Stolen, Damaged, or Missing (include SKUs or descriptions) * Long Text

6 Upload Supporting Evidence (photos, CCTV screenshots, receipts) File Upload

Witnesses

7 Witness Name(s) Short Text

8 Witness Contact Number Phone

Page 3 Reporting & Follow-Up 7 questions

Reporting Personnel & Actions Taken

1 Report Filed By * Full Name

2 Reporter's Email Address * Email

3 Reporter's Role * Dropdown

4 Immediate Actions Taken (e.g., suspect detained, area secured, merchandise recovered) * Long Text

5 Recommended Follow-Up Actions Multiple Choice

6 I certify that the information provided in this report is accurate and complete to the best of my knowledge. * termsandconditions

7 Reporter's Signature * Signature

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.