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PPM Accident Report
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Email
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Your email
Your Name and Phone Number
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Your answer
Describe who was injured and their phone number
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Your answer
Describe the injury, part of body part affected
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Your answer
Describe the type of medical attention provided (e.g., first aid, urgent care, called 911)
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Your answer
Briefly describe how the accident occurred including the equipment that was being used.
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Your answer
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