Accident Report


Submit the form electronically by clicking the submit button at the bottom, or PRINT OUT and mail to BBC, PO Box 131163, Birmingham, AL, 35213.


Date+Time of Incident:
Injured Person Name:
Address:
City, State, Zip:
Phone:
Email:
Incident Location:
Incident Description:
What could have been done to prevent another accident like this from happening?
 
Would you be willing to have this accident report printed in The Spokesman?
Yes:   Yes, anonomously:   No: