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school accident report form

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THE SCHOOL BOARD OF POLK COUNTY STUDENT ACCIDENT REPORT FORM Name Home Address School Sex: M Time Accident Occurred: Hour A.M. P.M. Place of Accident: School Building F Age: Grade Date School Grounds
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Of report. Name and description of person or persons involved in accident and the type of accident (passenger vehicle or non-passenger vehicle). Date of accident and driver name and description by which you are notified if a report is to be filed, if more than one person was involved. Date of the crash or accidents. Report details: Accident Description: Crash Number: Driver or Motorist: Reason for Crash: Date, Time, and Location of Crash. Description of Damage: Damage or injury to Vehicle: Type of Collision: Type of Occupation: (School Bus or Private Bus) What were you doing at the time of the accident? (Note: Some information in this section may be incomplete or wrong.) Date, Time, and Site of Crash: Accident Location: Type of Vehicle: (Bus or Motorcycle) Where were you at the time of the accident? (, near the accident scene, in a nearby building, on a busy street, or in the bushes.) What type of school is involved? (Note: If multiple vehicles involved, please include their owner information.) Class of School: (Note: If multiple types of schools are involved, please specify in your report, the specific class (public or specialized), school type (charter school), or school board) Who did you meet with as a parent or legal guardian at the time of the accident? When did you last see these students? For bus accidents, please also check which bus stopped and the location in which it was. When did you last see the buses you boarded for your trip? Accident Location: Type of Driver: (Driver involved in a motor vehicle accident, a pedestrian, a bicyclist, or a pedestrian attempting to cross the street at a crosswalk who was struck by a bus or by a pedestrian crossing the street at a crosswalk in a crosswalk when a bus hit a pedestrian; pedestrian; bicyclist; or motorcyclist. Please specify in your report: type of vehicle involved, type of pedestrian involved, type of bicyclist involved, type of pedestrian attempting a crosswalk crossing and then cross the street, type of driver involved, and driver location of the accident.) Who was driving the vehicle? (Please indicate the age and driver's license photo for each driver.) What was your relationship to the driver? (Note: If the driver was an infant (under 1-year-old) or older person, please indicate that parent.
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Instructions and Help about student accident report form
Okay leaders I am here to show you a new report form that we have if someone in your classroom gets injured please come find me I will grab one of these for you, and you need to fill out this top portion right here, and I will fill out the bottom but then just give it back to me, we'll figure it all out, but that's it I just wanted you to see it come find me if someone gets injured
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