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Accident Claim Worksheet

Use this accident claim worksheet to make sure you get all the important information that you need when you are involved in an accident. Also, there is a link below for a sample form letter that will help you get started with writting an accident claim letter.






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Advice About Documenting An Accident Claim

  • Fill out your accident claim worksheet immediately following an accident.
  • Be as specific as possible when listing out the details of the accident.
  • Make sure you get all the information that you need from the other party.
  • Consult your Attorney before sending any correspondence.



Accident Claim Letter



Accident Claim Worksheet

Word   PDF  



Accident Claim Worksheet


Date: ___/___/_____

Time: _____:_____

Location: _______________________________________

Description:

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

All parties that were involved:

________________________________________________________________

________________________________________________________________

________________________________________________________________

Witnesses:

________________________________________________________________

________________________________________________________________

________________________________________________________________

Insurance Information:

________________________________________________________________

________________________________________________________________

________________________________________________________________













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Continuous Improvement

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Accident Claim Letter
Accident Claim Worksheet
Injury Report Form
Employee Accident Log
Fire Drill Report



End Of Employment
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Two Week Notice Letter
Resignation Letter
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Exit Interview
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