Accident Report Form
Our mission is to aid in the prevention of climbing and mountaineering accidents. Accident reports, analysis, and suggestions for future climbers are welcomed. The person filling out this form should be directly familiar with the circumstances of the accident—either the person(s) involved or a rescuer involved in the incident. The persons involved may choose to remain anonymous, but please provide contact information so we can follow up with questions about the incident. At that time we will confirm which names (if any) will be used with the report.

Sign in to Google to save your progress. Learn more
Report Completed By *
`
Your Email Address *
Date and Time of Accident *
Geographic Location *
(Must be in North America. Please include: State/Province, Area/Mountain, Route Name or Aspect [north, south, etc.])
Persons Involved (and Ages) *
(Use full name or a number [ex., “Person 1”]. Provide ages and experience levels of persons directly involved.)
Experience Level *
(How long have you been climbing for?)
Total Number of Persons Involved *
Terrain *
Required
When *
Required
Primary Cause *
(You may check more than one primary cause)
Required
Contributory Causes
(You may check more than one cause)
Type of Injury
(You may check more than one)
Narrative Description of Accident *
(Use as much space as needed to tell the complete story of the accident. Please be specific and include events that led to accident, group's familiarity with area, skill level, objectives, route, hazard evaluation, weather, etc.)
Analysis of Accident *
(Provide your own analysis of what went wrong. What knowledge and techniques might help prevent similar accidents in the future?)
Third Party Analysis of Accident
(Provide additional analysis from others involved, including rescuers, guides, park officials, other agencies, or supporting information.)
Keep participants anonymous? *
Photos, Diagrams, and Graphics
Do you have photos, graphics, or diagrams that illustrate the setting or contributing factors of an accident? Please send them to us! Help others understand the scene and what happened. Simply email anam@americanalpineclub.org.
Compensation and Copyright
Accidents does not pay contributors. We have always depended on the generosity of contributors to create this essential resource for climbers.

The American Alpine Club (AAC) copyrights the entirety of Accidents in North American Mountaineering. However, authors and photographers retain all rights to their individual contributions. Unless specifically requested otherwise, Accidents will assume permission to publish all submitted text, photos, illustrations and other documents at the Accidents website (publications.americanalpineclub.org) or in the annual print edition of Accidents. The American Alpine Club also retains the right to republish your text and photographs in other Accidents-related publications, in print or online, with no compensation. Since authors and photographers retain all rights to their work, you may re-use it without permission from the AAC.

The American Alpine Club is a nonprofit organization that publishes and preserves authoritative climbing information and represents the interests of all climbers.
Made Possible by the American Alpine Club
Accidents is made possible by the AAC. Join the AAC at www.americanalpineclub.org to recieve rescue benefits and a print copy of Accidents in North American Mountaineering.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of American Alpine Club. Report Abuse
Google Forms