Intake

Claim Intake

  • All sections highlighted in yellow must be completed. If the submitter does not have all the information, the intake form can be saved as an incident until such time as all the pertinent information is obtained.
  • General Intake FormAccident Intake Form
  • School Incident Report Form For Insurance Purposes

  • 1 General
  • Add Witnesses   
  • 2 Injury/Loss Details

  • SECTION A
  • Add Injured Person   
  • SECTION B
  • 3 Submitter Information