Template Information
An accident incident report form is used when someone got injured as a result of collision. this template can be used by fleet managers to document the details of the incident. use this template to guide the inspector to perform the following: 1. capture all contact details and verification information of the injured person 2. describe full details of the injury and the accident 3. take photo evidence of the surroundings 4. record emergency services involvement (i.e. police, fire, paramedics), hospitalization information and witness statements 5. capture electronic signatures from the relevant person involved and injured person
Category: general
Template Questions
- Name of driver
- Driver's license number
- Car registration number
- Identification number
- Take photo of ID
- Injured Person Background
- Date of Birth
- Telephone Number
- Address Address
- Date and time of event Date
- What part of the body was injured? Describe in detail
- Take photo of the body part that was injured. Annotate as required
- Describe fully how the accident happened?
- Take photo of the surrounding
- Injury Details
- Witness Statements
- Enter witness name
- Contact number
- Witness statement
- Witness signature
- Emergency Services
- Injured person (Full Name and Signature)
- Fleet manager (Full Name and Signature)