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Emergency Responder Safety Institute Struck by Reporting Form ALL STRUCK BY INCIDENT REPORTS MUST BE MADE USING THE ONLINE FORM AT REPORTSTRUCKBY.COM THIS PAPER COPY OF THE FORM IS ONLY FOR DISPATCHERS
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How to fill out roadway response struck-by incident
How to fill out roadway response struck-by incident
01
Ensure the safety of yourself and others before responding to the incident.
02
Assess the situation and make sure the roadway is secure for you to enter.
03
Gather all necessary information such as location, vehicles involved, and any witnesses.
04
Document the scene by taking photos and notes of the position of the vehicles and any debris.
05
Contact emergency services if necessary and provide them with all relevant details.
06
File a report with the appropriate authorities and follow up as needed.
Who needs roadway response struck-by incident?
01
Roadway maintenance workers
02
Emergency responders
03
Law enforcement officers
04
Insurance companies
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What is roadway response struck-by incident?
Roadway response struck-by incident is an incident where a worker is struck by a vehicle or equipment while responding to an emergency on the road.
Who is required to file roadway response struck-by incident?
Employers or individuals in charge of roadway response activities are required to file roadway response struck-by incident.
How to fill out roadway response struck-by incident?
Roadway response struck-by incident can be filled out by providing details of the incident, including the date, time, location, and description of what happened.
What is the purpose of roadway response struck-by incident?
The purpose of roadway response struck-by incident is to document and investigate incidents to improve safety measures and prevent future accidents.
What information must be reported on roadway response struck-by incident?
Information such as the identities of those involved, injuries sustained, vehicles or equipment involved, and actions taken after the incident must be reported on roadway response struck-by incident.
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