Free Student Accident Report Form Template
Student Accident Report Form
Please fill out this form completely to report any accident involving a student.
Student Information
Name
Grade/Class
Age
Parent/Guardian Name
Phone number
Accident Details
Date and Time of Accident
Location of Accident
Description of Incident
Injury Details
Describe the nature of the injury
First Aid/Medical Treatment Provided
Witness Information
Name of Witness (if any)
Phone number
Reported By
Name
Phone number
Role/Title
Please check the box below to proceed
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