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Wild Sky Law Group - (425) 646-2773
"Helping you weather the storm."
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Email
*
Your email
COLLISION SCENE INFORMATION FORM
Use this form to collect information at a collision scene - This does not create an attorney-client relationship.
Date of collision
*
MM
/
DD
/
YYYY
Your name:
*
Your answer
Your email (this form will be emailed to you and you authorize us to contact by email)
*
Your answer
Your phone number (by submitting this, you authorize me to call you at this number)
*
Your answer
OTHER DRIVER INFORMATION:
Other Driver Name
*
Your answer
Other Driver Physical Address
*
Your answer
Other Driver Phone Number
*
Your answer
Other Driver's License Number
*
Your answer
Other Driver's Email (optional)
Your answer
Other Driver's Vehicle Year, Make, Model
*
Your answer
Other Vehicle License Number
*
Your answer
Other Vehicle Insurance Company
*
Your answer
Other Vehicle Insurance Policy Number
*
Your answer
TAKE PICTURES (*only if it is SAFE to do so*)
The other driver's vehicle (from multiple angles)
Your car (from multiple angles)
The scene of the collision (from multiple angles)
WITNESS INFORMATION (Name/Phone/Address/Email)
Your answer
A copy of your responses will be emailed to the address you provided.
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