Accident Checklist

Time:

Date:

Location/address/landmark:

Traffic/Road/Weather Conditions:

Describe the Accident (include speed, direction of travel, etc.):

Injury Information (you, passengers, bystanders):

First Responders (police, ambulance, fire dept.):

Damage to Your Vehicle:

REMAIN IN YOUR VEHICLE OR IN A SAFE LOCATION UNTIL HELP ARRIVES. DO NOT GET OUT OF YOUR VEHICLE IF YOU COULD BE STRUCK BY ANOTHER VEHICLE.

Collecting Evidence

If you are not injured and you can safely take pictures, do so. Do not try to take pictures if doing so will put you in harm’s way.

Take pictures of:

• License plates of involved vehicles
• Damage to your vehicle
• Damage to other vehicle(s)
• Location identifiers such as road signs, street signs, or address markers
• Damage to property at the scene of the accident
• Skid marks, accident debris, other evidence

DO NOT ALLOW YOUR DRIVER’S LICENCE TO BE PHOTOGRAPHED

Talk to eyewitnesses and gather their contact information.

Eyewitness 1:

Name

Phone Number

Address

City

State/Province

Zip/Postal

Country

Notes

DRIVER/VEHICLE INFORMATION

Name:

Vehicle Make:

Vehicle Model:

Color:

Year:

License Plate #:

VIN #:

Insurance Co:

Phone #:

Policy #:

IF INSURANCE INFORMATION IS NOT AVAILABLE

Driver Address:

City

State/Province

Zip/Postal

Country

Driver Phone:

Driver’s License #:

Police Officer Name:

Jurisdiction:

Badge #:

Report #:

Date and Time:

If no police report is filed, file an incident report for your claim

PROVIDE THIS INFORMATION TO OTHER PARTY

NAME:

VEHICLE MAKE:

VEHICLE MODEL:

YEAR:

COLOR:

VIN:

INSURANCE COMPANY:

INSURANCE AGENT:

AGENT’S PHONE:

POLICY NUMBER:

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Collecting Evidence

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