14/6/24, 13:58 Vehicle Accident Report - SafetyCulture

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Title Page

Client / Site

CONSTRUCTORA TALCA

Conducted on 

Prepared by

Abraham Morales

General Information

Date the accident happened 

Date and time of investigation 

Exact location of accident 

Take photo of the location where accident happened 

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Weather condition

Cloudy Clear Dark Fog Ice Rain Snow Twilight Windy

Type of Road Surface

Asphalt Concrete Dirt Gravel

Condition of Road Surface

Good Fair Poor

Vehicle Information

Vehicle type

Light Vehicle Heavy Vehicle

Select vehicle identification type

VIN License Plate # Other

VIN

Take photo of license plate 

Year, Make and Model

Driver's Speed

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Direction of Travel

North South East West

Accident Details

Select the root cause

Conflict Vehicle Bad

Reckless Driver with mechanical Caused weather Animal Other
Driving not passengers issue by crossing
attentive other
vehicles

Describe unattentiveness

Drunk Influenced by drugs Sick Other

Other reasons

What part/s of the vehicle had issues and caused the accident to occur?

List other root cause and provide detail information

Describe the incident

Describe the damages of vehicle

Slightly Damaged Severely Damaged

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Take photo of vehicle 

Provide detailed descriptions of the physical damages

Was there a collision?

Yes No

Draw a diagram of collision 

Provide details of the vehicle involved

Describe the damages of vehicle

Slightly Damaged Severely Damaged

Take photo of vehicle 

Provide detailed descriptions of the physical damages

After the accident, is the vehicle safely drivable?

Yes No

Was the vehicle towed?

Yes No

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Passenger Profile

How many people are involved in the accident?

How many are injured?

How many are fatal?

Click the "Add Passenger" button to list the passengers involved in the accident

Passenger

Name and Signature 

Ask the details about the incident

Recommendation

State some recommendations

Completion

Full Name and Signature of Inspector 

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solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.

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