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AUTO ACCIDENT QUESTIONNAIRE Date of Accident Brief description of accident Patients vehicle (yr., make, model) Ext. Speed MPH Patients vehicle hit by Ext. Speed MPH Time: % Day % Night % Dawn % Dusk
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How to fill out auto accident questionnaire

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How to fill out an auto accident questionnaire:

01
Start by carefully reading each question on the questionnaire. Make sure you understand what information is being requested.
02
Begin by providing your personal details such as your name, address, contact information, and driver's license number.
03
Provide the date, time, and location of the accident. Include specific details about the intersection or landmarks nearby if applicable.
04
Describe the weather conditions at the time of the accident. Was it raining, sunny, or foggy?
05
Indicate the road conditions at the time of the accident. Was the road wet, icy, or in good condition?
06
Explain how the accident occurred in as much detail as possible. Include information about the other driver involved, their vehicle, and any witnesses present.
07
Use diagrams or sketches to illustrate the accident scene if necessary. This can help provide a clearer understanding of the situation.
08
Describe any injuries sustained by either driver or any passengers involved in the accident. Be honest and include both visible injuries and any potential internal injuries.
09
Note any damage to the vehicles involved. Describe the extent and location of the damage.
10
Finally, sign and date the questionnaire to confirm that the information provided is true and accurate.

Who needs an auto accident questionnaire?

An auto accident questionnaire is typically needed by individuals who have been involved in a motor vehicle accident. This includes both drivers and passengers who may need to report the accident to their insurance company or provide information to law enforcement. The questionnaire helps gather all the necessary details about the accident to aid in the investigation or insurance claims process.
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An auto accident questionnaire is a form used to gather information about a car accident, including details about the drivers involved, the vehicles, and the circumstances of the accident.
Any driver involved in a car accident may be required to file an auto accident questionnaire, depending on the laws in their state or country.
To fill out an auto accident questionnaire, drivers must provide accurate information about the accident, including the date and time, location, descriptions of the vehicles involved, and any injuries or damages.
The purpose of an auto accident questionnaire is to collect essential information about a car accident that can be used by insurance companies, law enforcement, and other parties involved.
Drivers must report details such as the date and time of the accident, the location, the names and contact information of all drivers and passengers involved, descriptions of the vehicles, and a brief description of how the accident occurred.
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