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Motor Vehicle Accident New Patient Intake Form Last Name: First Name: MI: Other names: Date of Birth: Sex: Address: Apt: City: State: Zip: Email: Home phone: Work phone: Cell phone: May we leave confidential
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How to fill out motor vehicle accident new

01
Gather all the necessary information such as the date and time of the accident, location, and vehicle details.
02
Notify the authorities and emergency services if necessary.
03
Exchange information with the other party involved in the accident, including name, contact details, insurance information, and driver's license number.
04
Take photos of the accident scene, damaged vehicles, and any relevant factors such as road conditions or traffic signs.
05
Obtain witness statements if possible.
06
Report the accident to your insurance company and provide them with all the required documentation.
07
Follow any specific instructions given by your insurance company, such as visiting an approved repair shop.
08
Keep a copy of all documents related to the accident for your records.
09
Seek medical attention if you or anyone involved in the accident has sustained injuries.
10
Cooperate with any investigations or legal proceedings that may arise from the accident.

Who needs motor vehicle accident new?

01
Anyone who has been involved in a motor vehicle accident needs to fill out a motor vehicle accident report.
02
This includes drivers, passengers, and pedestrians who may have been injured or affected by the accident.
03
Filing a motor vehicle accident report is necessary to document the incident and facilitate the insurance claim process.
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