Road traffic Incident Report Road Traffic Incident ReportUsername(Required)Email(Required) Name of Driver(Required) First Last Vehicle Make/Model(Required)Registration Number(Required)Location of Incident(Required)Date(Required) DD slash MM slash YYYY Time(Required) Hours : Minutes Type of Incident Road Traffic Collision Product Spillage Onsite Accident Near Miss Lost Load Other Speed (KPH)Enter the speed at which the incident happenedWeather Conditions(Required)Describe the weather conditionsRoad Conditions(Required)Describe the condition of the roadRoad Signs(Required)What road signs were visible at the sceneGarda DetailsWas there a Garda present?(Required) Yes No When did the Garda arrive at the scene?(Required)Name of the Garda present(Required)Rank, Number and Station of the Garda(Required)Phone number of the Garda(Required)Other Vehicles InvolvedDetails of Other Vehicles InvolvedVehicle Make/ModelReg No.Driver NameContact DetailsInsurance detailsDescription of Damage Add RemoveWas a lost load or a spillage involved(Required) Yes No Details of spillage or lost load(Required)Enter detailsDetails of any injuriesWas anyone injured?(Required) Yes No Was an ambulance called?(Required) Yes No Details of Injured Persons(Required)Name of injured personContact detailsDetails of injuries Add RemoveWitnessesWere any witnesses present?(Required) Yes No Details of Witnesses(Required)NameContact Details Add RemoveDescription of the IncidentIncident Details(Required)Please enter a brief description of what happenedActions Taken at the Scene(Required)Please describe any remedial actions taken at the sceneAdd PhotosPlease add photos as required Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, Max. file size: 12 MB, Max. files: 10. Signature(Required)