Title Page
-
Client / Site
-
Conducted on
-
Prepared by
General Information
-
Date the accident happened
-
Date and time of investigation
-
Exact location of accident
-
Take photo of the location where accident happened
-
Weather condition
- Cloudy
- Clear
- Dark
- Fog
- Ice
- Rain
- Snow
- Twilight
- Windy
-
Type of Road Surface
-
Condition of Road Surface
Vehicle Information
-
Vehicle type
-
Select vehicle identification type
- VIN
- License Plate #
- Other
-
VIN
-
Take photo of license plate
-
Year, Make and Model
-
Driver's Speed
-
Direction of Travel
- North
- South
- East
- West
Accident Details
-
Select the root cause
- Reckless Driving
- Driver not attentive
- Conflict with passengers
- Vehicle mechanical issue
- Caused by other vehicles
- Bad weather
- Animal crossing
- Other
-
Describe unattentiveness
-
Other reasons
-
What part/s of the vehicle had issues and caused the accident to occur?
-
List other root cause and provide detail information
-
Describe the incident
-
Describe the damages of vehicle
-
Take photo of vehicle
-
Provide detailed descriptions of the physical damages
-
Was there a collision?
-
Draw a diagram of collision
-
Provide details of the vehicle involved
-
Describe the damages of vehicle
-
Take photo of vehicle
-
Provide detailed descriptions of the physical damages
-
After the accident, is the vehicle safely drivable?
-
Was the vehicle towed?
Passenger Profile
-
How many people are involved in the accident?
-
How many are injured?
-
How many are fatal?
-
Click the "Add Passenger" button to list the passengers involved in the accident
Passenger
-
Name and Signature
-
Ask the details about the incident
Recommendation
-
State some recommendations
Completion
-
Full Name and Signature of Inspector
