Accident Report Form for Painted Bar Stables

Please only use facts that you WITNESSED of the accident. Do not report secondary information or evaluate horses as longstanding problems. Only use witnessed facts that occurred during the incident.

Please keep information private. Only barn staff will be able to view the results. All information reported is confidential for both the horse and the rider.

Improper or absuive use of this form will result in reprimand.

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    Incident Information

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    Equipment Involved

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    Horse Involved in Incident

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    Instructor Information

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