Accident Report

STOP!!!!! If you or another person is injured, please call 911.

Please remain calm and call your manager to inform them of the accident.

Do NOT admit fault or describe the specifics of the accident to any other parties.

DO cooperate with police on the scene.

DO take photos. Please get pics of the damage to all vehicles and property and get pics of the accident scene.

Please complete the form below and submit it ASAP. You will complete a full accident report with your manager at the end of your shift.

Name

First Last

Phone

Location/Address of accident

Any injuries?

Any vehicles require a tow-truck?

Brief description of what happened

Driver Name

First Last

Driver Phone

Driver Email

Driver Address

Street Address Address Line 2 City State ZIP Code

Other party vehicle information

Name

This field is for validation purposes and should be left unchanged.

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