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Accident Report

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Email
District Name
required

South Elementary Principal: Katherine Dawe

Email: [email protected]

South Elementary Phone number: (406)628-3380



West Elementary Principal: Bethany Fuchs

Email: [email protected]

West Elementary Phone number: (406)628-3400



Graff Elementary Principal: Lynne Petersen

Email: [email protected]

Graff Elementary Phone number: (406)628-3450



Laurel Middle School Principal: Justin Klebe

Email: [email protected]

Laurel Middle School Phone number: (406)628-3900


Laurel Middle School Vice Principal: Allyson Robertus

Email: [email protected]

Laurel Middle School Phone number: (406)628-3900



Laurel High School Principal: Stacy Hall

Email: [email protected]

Laurel High School Phone number: (406)628-3500


Laurel High School Vice Principal: John Stilson

Email: [email protected]

Laurel High School Phone number: (406)628-3500


Claimant's Sex
required
Nature of Injury
required
Place of Accident
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Body Part Injured
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Were efforts made to contact the parent/guardian about the accident?
required
Was first aid administered?
required

Optional

Where was the student sent?
required
Is student covered by Student Accident Insurance?

If medical or hospital treatment was required, please complete the following information.

(Attach a copy of medical bills, if available.)

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Witnesses
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