Accident Reporting

Accident report
Time
:
Wearing seat belt
Using cell phone
Airbags deployed

Information about other vehicles

Information About the Accident

Police involved *

Information about injuries

If injuries were to the employee an employee injury/investigation report must be completed

Gender
Traveling in your vehicle
Traveling in other vehicles
Pedestrian
Was the driver in control of the vehicle at the time of the incident
Were pictures taken *

Employee Vehicle Accident Review

(For reviewing all vehicle accidents. To be filled out by the driver. Not for claim purposes.)

Seat belts worn
Were you on the cell phone