[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Store Manager's Name] [Store Name] [Store Address] [City, State, ZIP Code] Subject: Slip and Fall Accident on [Date] at [Store Name] Dear [Store Manager's Name], I hope this letter finds you well. I am writing to bring to your attention an unfortunate incident that occurred on [Date] while I was shopping at your store, [Store Name], located at [Store Address]. I am reaching out to express my concern regarding the slip and fall accident that transpired within your premises, which resulted in injuries on my part. On the mentioned day, I visited your store as an esteemed customer with the intent of completing my routine shopping. However, as I was browsing through the aisles, my foot suddenly slipped on a highly wet and unmarked surface near the entrance of the store. This caught me off guard, causing me to lose my balance and fall with significant force onto the hard floor. Subsequently, I experienced severe pain in my lower back and observed swelling in my ankle. In light of these injuries, I sought immediate medical attention, and my healthcare provider confirmed the presence of a sprained ankle and potential damage to my back. As a result, I have incurred medical expenses, physical therapy costs, and suffered physical pain and emotional distress due to the incident. Given my loyalty and frequent visits to your store, this unfortunate accident has left me deeply concerned about the safety measures implemented to ensure customer well-being within your premises. I believe it is essential to address this matter promptly, to prevent similar incidents from occurring and to safeguard future customers. In light of the aforementioned events, I kindly request that you take the following actions to resolve the issue: 1. Conduct a thorough investigation into the circumstances leading to the slip and fall accident on [Date]. 2. Review and enhance safety measures, including regular inspections, prominently placing warning signs near potential hazards, and promptly addressing any spills or wet surfaces. 3. Provide compensation for the incurred medical expenses, physical therapy costs, and any other associated expenses resulting from the accident. 4. Assure that measures are implemented to prevent similar accidents from happening in the future. To expedite the resolution process, I have attached copies of my medical bills, treatment records, and any other relevant documentation regarding the incident. I kindly request that you acknowledge receipt of this letter within [number of days] and provide a timeline for when I can expect a formal response addressing my concerns. Please note that the purpose of this letter is not to threaten legal action but to amicably address and resolve the matter. However, should my concerns not be adequately addressed, I may have no choice but to seek legal advice to safeguard my rights as a customer who suffered injuries due to negligence. I genuinely hope we can resolve this matter in a fair and amicable manner. I believe that your store values its loyal customers and prioritizes their safety. Furthermore, I look forward to your prompt attention to this matter and a satisfactory resolution. Thank you for your immediate attention to this serious matter. I trust that you will handle it with the utmost concern it deserves. Yours sincerely, [Your Name] [Your Contact Information]
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.