Get Statement Of Injury - Ewtforg

Completing the Statement Of Injury - Ewtforg form is essential for sharing critical information about an injury or accident. This guide will help you understand each component of the form and provide step-by-step instructions to ensure accurate completion.

Follow the steps to fill out the Statement Of Injury - Ewtforg online.

1. Press the ‘Get Form’ button to access and open the form in the online editor.
2. In Section 1, indicate the type of accident related to the injury by checking all applicable boxes, including automobile accidents, job-related accidents, or sports-related injuries.
3. In Section 2, provide the employee’s name, social security number, and address. Include the name of the injured person, their relationship to the employee, email address, and zip code, along with the date of the injury or accident.
4. In Section 3, detail the location of the accident, including a complete address. Describe the circumstances of the accident as fully as possible; attached additional sheets if necessary.
5. List all injuries sustained, selecting relevant options such as sprains, cuts, or fractures. If pain is related to existing conditions, clarify how it started.
6. Indicate whether a police report was filed by selecting 'YES' or 'NO.' If 'YES,' ensure to attach a copy of the report.
7. List any other individuals involved, along with their insurance company details and provide necessary contact information.
8. Answer additional questions regarding motorcycle insurance, claims with worker’s compensation, and any other relevant information regarding potential filings.
9. At the end of the form, review your information carefully and sign the document. Ensure to include the date and any required notarization as instructed.
10. Finally, save your changes, then download, print, or share the completed form as necessary.

Complete your Statement Of Injury - Ewtforg form online today to ensure your claims are processed promptly.