WCW Fleet Incident Reporter

Incident Basics

Capture the when, where, and what dispatch knows so far. You can refine details on later steps.

Incident date *

Incident time

Street address or nearest mile marker *

City *

State *

ZIP *

Road conditions at time of incident

Weather at time of incident

Accident type *

Accident sub-type *

Fault determination *

Site *

Region *

Severity *

Select the tier that best matches the incident. Use the injury level as your primary guide — vehicle damage and operational impact help confirm.

Tier 1 — Minor No injury — or first-aid only (band-aid, ice pack) Cosmetic or minor damage; vehicle drivable Route completed or quickly reassigned

Tier 2 — Moderate Injury requiring clinic or urgent care visit (driver returns to work) Functional damage; repairable but may need shop time Route delayed or vehicle swap required

Tier 3 — Serious EMT called or hospital visit — driver cannot continue working Major damage; vehicle towed or undrivable Route fails; full reassignment or service disruption

Dispatch summary of incident *

Factual summary written by dispatch based on the driver's report and any other information available. Stick to facts; avoid speculation about fault.

Driver statement (as relayed) *

The driver's account in their own words. Copy-paste from text messages if available, or paraphrase from the phone call.

Vehicle / Asset Details

Identifying details for the WCW vehicle involved.

Unit # *

Year

Make *

Model *

VIN *

License plate *

Ownership type *

Was the WCW vehicle towed from the scene? *

Yes — towed No — drove off scene Unknown

Driver / Compliance

WCW driver involved + post-accident compliance steps.

Driver Identity

Driver name *

Employee ID *

Phone *

Time with WCW *

Hours driven today

License

License type

Post-Accident Compliance

Per company policy, drivers must be drug and alcohol tested following an accident. Confirm the test has been scheduled or completed and capture the details below.

Drug & alcohol test status *

Testing facility / collection site (if known)

Other Parties Involved

Capture other drivers or property owners involved in the incident. Answer both questions.

Was another vehicle involved? *

Yes No Hit and run — party fled

Yes: another driver was involved and info was exchanged. No: single-vehicle incident or no other driver involved. Hit and run: another driver was involved but fled the scene.

Was property damaged with a known owner? *

Yes No

Yes: damaged a fence, building, sign, or other property where the owner's info was obtained. No: damaged public property (guardrail, state signage) or no property damage. You'll still describe the damage on Step 7.

Witnesses

Anyone who saw the incident

Witness 1

Name

Phone

Statement

Police & Citations

Document law enforcement involvement. Some incidents are reported later — that's normal.

Police involvement *

On scene Filed later Not involved

On scene: officers responded and a report was started. Filed later: no officer at the scene, but a report was or will be filed at the station / online. Not involved: no police report (e.g., minor parking-lot incident).

Damages & Injuries

One card per vehicle involved. Cards auto-populate from the Vehicle and Other Parties steps.

Property & Injuries

Damage to anything that isn't a vehicle, plus any injuries.

Property damage description *

Guardrail, signage, building, dock, fence, landscaping, etc. Type N/A if none.

Injuries description *

Who is injured, what body part, severity. Type N/A if none. Note: a driver claiming "I'm fine" is still worth noting.

Ambulance called? *

Yes No

Hospital (if known)

Product / Load

Capture what was on the truck. Detailed product-loss fields appear only if product was actually affected.

Load type

Was product damaged or discarded as a result of this incident? *

Detailed product info (temperature, categories, dollar loss, condition) is only required if the answer is Yes — that's what an insurance carrier needs to evaluate a product-loss claim.

Yes — damaged or discarded No — load intact Unknown — still assessing

Photos & Documentation

Organized uploads make claims process faster. Use the right category for each file — it tells Sterling Thompson exactly what they're looking at.

What to ask the driver for:

Wide shots of the scene from multiple angles (before any vehicles move, if safe)
Close-ups of damage on every vehicle involved
Photos of the other vehicle's license plate, insurance card, and driver's license
The police report (or report number) once available
Photos of any property damage (guardrails, signs, etc.) or injuries

Scene Photos

Wide shots showing all vehicles, road conditions, signage, and surroundings. Take from multiple angles before vehicles are moved.

+ Add Scene Photos

Damage Close-Ups

Close-up shots of damage on each vehicle. Label which vehicle in the file name if possible (e.g., "WCW-truck-rear-bumper.jpg").

+ Add Damage Photos

Other Vehicle / Driver

Other vehicle's license plate, insurance card, driver's license, and any visible damage to their vehicle. Critical for the claim.

+ Add Other-Party Photos

Documents

Police report, citation, repair estimates, tow receipts, BOL, driver's statement (if written), medical records. PDFs and photos both work.

+ Add Documents

Other / Property / Injury

Property damage (guardrails, buildings, signs), injury photos (with consent), or anything else that doesn't fit the categories above.

+ Add Other Files

Samsara Dashcam Video

Upload the Samsara video clip for this incident if available. MP4 format, 50 MB max.

+ Add Dashcam Video

Review & Submit

Confirm everything before sending

Verification

Report Filed By *

Name and email of the person filing this report. Required for compliance tracking and follow-up.

Full name *

Role / Title

Email *

On submit, this report will be sent to:

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Additional recipient (optional)

Send a copy to a supervisor or other contact. Enter their email below.

Fleet Incident Reporter