Incident Report | Approach Management Services

In an emergency

For serious incidents, call 911

If you’re an Approach client, activate our safety team by calling 800.626.0846. We’re available 24/7 for crisis response.

If you need immediate assistance from your claim manager, call 206-812-3850 or email us.

General
Date Accident Occured*
Time

: HH

MM
Name of injured employee*
First Last
Company Name*
Specific Location or Site*
Company Phone Number

Incident Details
How did it occur?
What was the injured party doing?
Describe the injury
What part of the body was injured?
What medical treatment was given?
Date of Medical Treatment
Report Completed By:
Email

We will send a copy of the completed form to this address

Contact Information
Do you need a callback?
Callback Phone Number
Existing Claim Number (If Known)

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