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Environmental Health and Safety

Auto Accident Investigation Form

At the accident scene:
  1. Notify local police by phone at 911, and ambulance if necessary. Do not leave the accident scene until local police have responded.
  2. Notify University Public Safety by phone at 202-885-3636.
  3. Do not admit liability or fault, only explain what happened.
  4. The Risk Management Office will automatically be notified of your accident upon the submission of this form, and will contact you shortly regarding the next steps in the process.
If time is unknown enter 12:00PM

   
   
If so, provide the name and nature of the injury for each injured individual.

Describe the accident and any damages. Include the cause of the accident, any contributing factors, and the names and numbers of any witnesses. Include the make, model, year and license number of the vehicle(s) involved. Include the contact and insurance info for the other driver(s). Also, include the purpose of the trip. If any pictures were taken, please attach them.