Accident Report Form

This form should be utilized to report accidents that occur on Elon University's campus or involve university employees, students and guests. Reports should be submitted within 24 hours of the accident.

  • Information about Injured Person

  • Information about the Incident

  • Select date MM slash DD slash YYYY
  • :
  • Please provide street address or closest landmark, when possible.
  • Describe what happened, how it happened, factors leading to the event, etc. Be as specific as possible. If a University vehicle was involved, please include the license plate number.
  • Drop files here or
    Max. file size: 49 MB.
      Please attach photos of vehicle or property damage, if pertinent.
    • Please describe the injury (laceration, sprain, etc.), the part of body injured, and any other information known about the resulting injury(ies).
    • Provide names, phone numbers and email addresses of witnesses, if present.
    • Complete only if police were notified (Campus Safety & Police, Elon Town Police, Burlington Police, etc.)
    • Employees must provide return to work restrictions to supervisor and Risk Management and Insurance. Employees must be approved to return before resuming job duties.

    • Reporter Information

    • Clear Signature
    • Select date MM slash DD slash YYYY
    • This field is for validation purposes and should be left unchanged.