Adam Bramwell

Accident Form

To be used following an accident involving a company vehicle.

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Use this Template

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Title Page

Conducted on
Prepared by
Location
Your safety and well-being are priority, make sure yourself and anyone else involved are safe and not injured.

If anyone is injured, please contact the emergency services immediately.

Don’t admit liability.

Check the surrounding area is safe and does not present a hazard to other road users.

Third Party Details

Name
Address
Car registration
Make and model of your car
Insurance provider
If known can you provide your policy number

Incident

Are you reporting this later then it actually occurred?
When did the incident occur?
Where did occur.
In your own words, describe what happened?
Take pictures of the incident, as many as possible including both close up of the damage and from a distance include anything that you feel is relevant.
Contact the fleet administrator on. XXXXXXXXXXXXX

Adam Bramwell

Accident Form

To be used following an accident involving a company vehicle.

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.