Restaurant Accident Report Form

A restaurant accident report form is a formal document which is used to record the details of an accident which occurred in a restaurant. Any such form is given to a restaurant owner to put down the various accident specifications such as the time, date, injured people, number of articles lost etc…These forms contain many fields which are required to be filled so that the investigating authorities can understand the cause of the accident and have the details of the objects which were insured and for which compensation charges have to be paid. A sample of a restaurant accident report form has been provided in the following lines.

Sample Restaurant Accident Report Form:

RESTAURANT ACCIDENT REPORT FORM

Please fill in the following form if you are the owner or manager of a restaurant in which an accident has occurred:

Restaurant details:

Name of the restaurant: _______________                      address of restaurant: _______________

Phone number of restaurant: ________________             email address: _____________________

Name of restaurant owner: _____________    name of restaurant manager: ________________

Time details:

Date of accident: _____________                        Time period of accident: ______________

Estimated start time of accident: __________   estimated finishing time of accident: ______

Time details:

Date of accident: _____________                        Time period of accident: ______________

Estimated start time of accident: __________   estimated finishing time of accident: ______

Category of accident: [fire/roof collapse/construction problem/water overflowing/murder attempt/robbery/other]

Cause of accident: _________________________

Names of people injured: ___________________

Names of people dead, if any: _____________________

Name of investigating officer: _______________________

Signature of the investigating officer: _________________

Signature of restaurant owner: ____________________

Category: Report Forms