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Incident Report
Incident Report
If you have been involved in an accident and suffered an injury with one of our products, please fill out the form below and someone will be in touch with you to review the details.
DATE OF THE INCIDENT:
INJURED PARTY’S NAME:
INJURED PARTY’S ADDRESS:
CITY, STATE, ZIP CODE:
EMAIL ADDRESS:
PHONE NUMBER:
BRIEF DESCRIPTION OF INCIDENT AND INJURY:
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