This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
Minnesota Student Accident Report Form
Category:
State:
Multi-State
Control #:
US-02520BG
Format:
Word;
PDF;
Rich Text
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How to fill out Student Accident Report Form?
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FAQ
Accident report forms should include fields for names and contact information of the individuals and witnesses involved, the type of accident, the date and time the accident occurred, the location of the accident, a detailed description of the accident, and room for any additional comments.
Writing any incident report involves four basic steps. Respond Immediately. Employees should notify their supervisor as soon as an accident or injury occurs. ... Find the Facts. ... Analyze. ... Complete Corrective Action Plan.
Accident report forms should include fields for names and contact information of the individuals and witnesses involved, the type of accident, the date and time the accident occurred, the location of the accident, a detailed description of the accident, and room for any additional comments.
Provide date and time of the incident and when it was first reported, details of witnesses, and a succinct statement describing the events leading to the incident, the details of the incident, the type of work being undertaken, any hazards involved in the work and any personal protective equipment being used.
Keep in mind that these three considerations are not to be confused with the three requirements for writing an incident report: The report must be factual and without assumption. An incident report must be accurate and without bias. The incident report must be complete.
Complete a Crash Record Request Form (PS2503) and either mail it to the address on the form or visit the DVS Records/Evaluation Counter located at 445 Minnesota Street in St. Paul. Requests will not be processed without a signature from an Authorized Requestor.
In case of serious personal injury or death to anyone, immediately call Risk Management Division at (651) 201-2594. You must submit a crash report within 24 hours on required forms. Contact your fleet coordinator or go to mn.gov/admin/risk/insurance.