Get Nj Bollinger Schools Student Accident Claim Form 2020-2025

Filing a student accident claim can be a straightforward process when you have the right guidance. This comprehensive guide will walk you through each section of the NJ Bollinger Schools Student Accident Claim Form, ensuring you have everything you need to complete it accurately and efficiently.

Follow the steps to successfully complete the claim form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in the school district or diocese. This section helps identify the relevant administrative body. Next, specify the school within the district or parish that your child attends.
3. In the claimant's information section, input the last name and first name of the student, along with their date of birth and gender. Also, provide the telephone number and home address, including city, state, and zip code.
4. Complete the personal email address of the parent or guardian. This will be essential for communication regarding the claim.
5. Check the activity in which the student was involved at the time of injury. Be sure to select one option that applies and include the starting time and dismissal time.
6. Describe how the accident occurred and where it took place. Specifically, mention the part of the body that was injured.
7. The school official must complete their portion of the form by signing and indicating their title and contact information.
8. The parent or guardian must complete the medical authorization and payment authorization sections by signing and dating those areas.
9. Provide information regarding the parents’ or guardians’ names and their employers. State whether there is any personal or group medical insurance coverage and include details of other insurance companies if applicable.
10. Finally, ensure you have completed and signed all required sections. Save your changes and download or print the completed form. You may also share it as needed before mailing it to the claims administrator.

Complete the NJ Bollinger Schools Student Accident Claim Form online today to ensure a smooth claims process.