Accident Report Template

This accident report template has 3 pages and is a MS Word file type listed under our business plan kit documents.

Sample of our accident report template:

ACCIDENT REPORT Section 1: General Information Report Date: ____________________________________ Time of Accident: ____________________________________ Location of Accident: ____________________________________ Reporter's Name: ____________________________________ Reporter's Contact Information: [Enter phone number, email] ____________________________________________________________________________________________________________________________________________________________________ Relationship to Accident: [Witness, Involved Party, Other (please specify)] ____________________________________________________________________________________________________________________________________________________________________ Section 2: Involved Parties Information Name of Person(s) Involved: [Enter names] ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Contact Information: [Enter phone numbers, emails] ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Injuries (if any): [Describe injuries] ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Property Damage (if any): [Describe damage] ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Section 3: Accident Description Description of the Accident: [Provide a detailed account of what happened, including events leading up to the accident] ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Cause of the Accident: [Identify what caused the accident, if known] ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Section 4: Witness Information