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Write down their name, home address, birth date, and gender. You'll also want the name of the state that issued their license, their license number, and the date it expires. Give them this information for yourself as well. If the other driver does not have insurance or identification, call the police.

Date, time, and specific location of incident. Names, job titles, and department of employees involved and immediate supervisor(s) Names and accounts of witnesses. Events leading up to incident. Exactly what employee was doing at the moment of the accident.

Describe How the Accident Happened Include every detail of what you saw and heard and felttwists, blows, and shocks to your body immediately before, during, and right after the accident. Also include anything you remember hearing anyonea person involved in the accident or a witnesssay about the accident.

Provide general details of the driver (full name, driver license number, VIN etc) Add description and sketch the scenario. Take and annotate unlimited photos as evidence for your case. Include signatures and statements from witnesses if applicable.

Describing an accident As the driver was rounding the corner, he drove straight into another car which was on the wrong side of the road.A lorry jackknifed, spilling its load over the road. A car skidded on a wet / oily surface and the driver lost control. The brakes failed / the car driver misjudged the distance.

Date, time, and location of the incident. Names of everyone involved, including witnesses. Events that led up to the incident. Environmental conditions. Circumstances. Specific injuries. Damage to equipment or area.

The definition of an incident is something that happens, possibly as a result of something else. An example of incident is seeing a butterfly while taking a walk. An example of incident is someone going to jail after being arrested for shoplifting. An event or occurrence.

The incident report for an accident or injury such as a fall should include the following information: Circumstances of the incident. Date, time, and location of fall, and during which shift and on what unit the fall occurred. Witnesses', staff members', and resident's accounts of the incident.

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Yellow page is to be kept with the child's health record. This form may be used to notify parents of illnesses or injuries occurring with their children while in care. •.Any suspected child abuse or neglect of any child in care.

Child Accident And Injury Report Form

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