Stop at once and identify yourself.

Show your driver's license and registration to the other driver, the injured persons, and to any police officer.

If injuries appear serious, call an ambulance. If you feel you were injured in any way, see a physician promptly. It is important for you to seek treatment right away.

Report the accident to the Department of Motor Vehicles within ten days if property damage exceeds $___ (check with your local DMV to confirm amount) and /or injury or death results.

Write a complete description of the accident as soon as possible. If possible, take pictures, even if this means returning to the scene of the accident at a later time.

Notify your insurance company, even if the claim appears small and there are no apparent injuries. Settling the claim yourself is dangerous. Follow all prescribed procedures when reporting an accident to your insurance company.

Have even minor damage repaired. Letting your car go unrepaired can cost you in the long run. Dents and rust spots deduct from the resale or trade-in value of your car. You will pay for it eventually, so drive a car that's in first class condition now.

City:

Address:

Address:

Report #:

Policy #:

Color:                               # of passengers:

Do not discuss responsibility

Do not discuss the circumstances of the accident with anyone except the police and a positively identified representative of your insurance company.

Never give a signed statement to the claims adjuster representing the other driver's insurance company. The same goes for a phone recording. If you are being pressured, you may wish to consult an attorney.

Don't be fooled by the "lower estimate". There is a big difference in body shops. A low bid could reflect an incomplete job. When some items (such as alignment) are overlooked on a repair, the consequences to the driver can be serious. An improperly repaired car, especially one with heavy structural damage, can be very dangerous. Exercise your right to determine which shop will repair your car. Make sure every detail has been attended to and repaired to your complete satisfaction before signing any insurance company release.

Don't allow your car to be towed to a repair shop you are not familiar with. Don't authorize repairs by signing a towing release unless you have decided to have your car repaired by the shop your car is being towed to. Read and understand all papers before you sign them.  

Draw a diagram of the accident showing the direction of the vehicles involved and the point of accident. Show street names and location of street signs, stop signs, lights, etc.

Describe any other damage or pertinent information below.