Accident Report

First Steps

Remain Calm
Get to a safe place
Check for injuries
Administer First Aid
Call Police EMT

DO NOT SAY

“It’s all my fault” (even if it is)
“My insurance will pay for this”
“It’s ok, I have full coverage”

While still on site

Get as much information as possible on this report
Take Pictures (email to Michelle)
When police arrive, cooperate and tell them what you know

"*" indicates required fields

Accident Details

Technician Name*

Technician Truck #*

Time of Accident*

Weather/Road Conditions*

Location of Accident*

Accident Details - What Happened*

Passengers/Injuries

Total Passengers in your vehicle*

Injuries in your vehicle*

Total Vehicles Involved*

Total Passengers in other vehicles*

Injuries in other vehicles*

All Drivers involved with incident (Click + to add more)*

Driver's Full Name

Driver's Phone

Pictures Required

Pictures Of Damage To Done Vehicle*

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures Of Damage To Done Vehicle

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures Of Other Damage (vehicles, property, etc.)*

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures Of Other Damage (vehicles, property, etc.)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures Of Other Damage (vehicles, property, etc.)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures Of Other Damage (vehicles, property, etc.)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Vehicle(s) License Plates*

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Vehicle(s) License Plates

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Vehicle(s) License Plates

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Vehicle(s) License Plates

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's Insurance Card(s)*

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's Insurance Card(s)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's Insurance Card(s)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's Insurance Card(s)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's Registration(s)*

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's Registration(s)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's Registration(s)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's Registration(s)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's License(s)*

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's License(s)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's License(s)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Other Driver's License(s)

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.

Pictures of Police Officer's Card (INCLUDING CASE NUMBER)*

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB.