Accident Report Form

An accident report form records essential details concerning an accident that has occurred.  This accident report form is used by insurance companies, employers, institutions and organizations.  It enables these companies to have documented proof of accidents.  This enables them to avoid malicious lawsuits that could cost a lot of money.

Sample Accident Report Form

Please fill out the following information accurately and truthfully.

Please state the date when the accident occurred.

________________________________________________________________________

Please state where the accident occurred.

________________________________________________________________________

Please state any injuries incurred during the accident.

________________________________________________________________________

Please state any damage to property caused by the accident.

________________________________________________________________________

Please state the actions takes following the accident.

________________________________________________________________________

Please give details of those contacted about the accident.

Name: _______________________ Occupation: _________________________

Reason for being contacted: _________________________________________________

Name: _______________________ Occupation: _________________________

Reason for being contacted: _________________________________________________

Please sign here below to acknowledge that all the information given is truthful and accurate.

Sig: ___________________________ Date: _______________________________

Category: Report Forms