School Accident Report Form
School Accident Report Form
Please fill out this form to provide details about the accident.
Accident Details
Date and Time of Accident
Location of Accident
Description of Accident
Student Involved
Name
Grade Level
Were any injuries sustained by the student?
If yes, please describe the injuries
Action(s) Taken
Select all that apply:
-
First Aid Administered
-
Called Parent/Guardian
-
Emergency Services Contacted
-
Reported By
Name
Job Title
Name:
Date:
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