Auto Accident Checklist

To print PDF version, click Checklist for Auto Accidents.

Use this form in case of an auto accident.  The form should be filled out at the scene or shortly after leaving the scene. Provide a copy to your attorney.

The Accident:
Date of accident______________________
Time_________________
Location of accident ____________________________________
Type of road (grade, curve, etc.) _________________________
Speed of your car just before accident ____________________
Speed of other car just before accident ___________________
Direction of your car ____________________
Direction of other car ____________________
Were you turning? ______________________
Was other driver turning? _________________
Did the other driver signal properly (with arm, horn, lights, etc.)? ___________________
If at night, were other vehicle’s lights on? _______
How far away from you was the other car when you first saw it? ____________________
Other pertinent facts:
____________________________________
____________________________________

The Other Driver and His or Her Car:
Name:___________________________________
Street Address:_____________________________
City__________________________ State __________ Zip ______
Vehicle registration/year/license number________________________
Make/model of car_________________________ Year___________
Driver appear to have been drinking?__________________________
Any statement made by other driver as to cause of accident:
________________________________________
________________________________________

Passengers in Other Car:
Name:_________________________________________
Address:________________________________________
Name:__________________________________________
Address:________________________________________

All Possible Witnesses to Any Fact:
Name:___________________________________________
Address:__________________________________________
Name:____________________________________________
Address:___________________________________________
Conditions Noted Immediately after the Accident:
Position of your car after accident ____________________________
Position of other car after accident____________________________
Location of any tire marks, blood, broken glass, dirt, etc. on road or side of road ____________________
Location of point of impact in relation to center of road or some physical object ___________________
Did your car skid? _______________
If so, how many feet?___________________________
Did other car skid? _______If so, how many feet?______________
Road conditions_____________________
Traffic conditions____________________
Weather conditions___________________
Traffic controls (traffic lights, stop signs, etc.) _____________________
Place of impact on other car __________________________________
Name/address of wrecker that removed other car ______________________________________________________________________________

Other conditions that affected accident:
_________________________________________________________
_________________________________________________________

Information Produced By the South Carolina Bar Association