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Page 1 of 2INJURY/ACCIDENT QUESTIONNAIRE ADMINISTRATORS FOR EMPLOYEE BENEFITS PLANS Mailing Address: P.O. Box 1894 Tacoma, WA 98401 Physical Address: 1101 Pacific Ave. Suite 300, Tacoma, WA 98402
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How to fill out injuryaccident questionnaire
How to fill out injuryaccident questionnaire
01
Here's how to fill out an injury accident questionnaire:
1. Start by providing your personal information such as your name, address, and contact details.
02
Next, provide details about the accident such as the date, time, and location.
03
Describe the circumstances of the accident in detail. Include information about any witnesses present at the scene.
04
If there were any injuries involved, provide a detailed account of the injuries sustained by each person and the medical treatment received.
05
If there was any property damage, provide information about the extent of the damage and any repairs or costs incurred.
06
Answer any additional questions or provide any other relevant information requested in the questionnaire.
07
Review the questionnaire for accuracy and completeness before submitting it.
08
Sign and date the questionnaire to confirm the information provided is true and accurate.
Who needs injuryaccident questionnaire?
01
An injury accident questionnaire is typically needed by individuals who have been involved in an accident and need to report the incident to insurance companies, law enforcement agencies, or other relevant authorities.
02
It can also be used by legal professionals, insurance adjusters, or investigators working on behalf of accident victims to gather essential information for the purpose of claims or legal proceedings.
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