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Employee Accident Letter
This sample incident letter from employees allows staff to describe and document an accident or workplace injury. The statement provided should be concise and speak in a factual manner about the events that occurred in chronological order.

Free Sample Template
Format: Word PDF
# of Pages: 1
Printable: Yes


Other forms related to workplace accidents
About Employee Accidents
Employee Accident Report
Accident Analysis Worksheet
Accident Report Log


Employee Accident Letter TemplateForm 1003
Format: Word PDF
Category: Employee, Accident
Type: Letter


Employee Accident Letter

[Your Name]
[Address]
[City, State, Zip]



[Date of letter]

[Recipientís Name]
[Title]
[Company Name]
[Address]
[City, State, Zip]



Dear [Recipientís name],

I am writing you today to report an accident that occurred on ___/___/____ at __:__ AM/PM. Location: ______________________________________________________________________

John was cleaning the roof and gutters of the above mentioned location and was almost finished when he turned and lost his balance and fell off the roof. Fortunately, John landed on the grass and will be alright. To be safe I took John to the hospital emergency room to be examined. The doctor confirmed that John had no broken bones and will be able to return to work tomorrow.

I have placed John on the ground crew for the next week and further discussed safety precautions with him.

Best regards,


[Your Signature]