Fall evidence checklist

Checklist

• Photos of the hazard before it’s cleaned, from close and far away
• Photos of your shoes, clothes and injuries
• The name of the manager and the incident report number
• Names and phone numbers of witnesses
• Your receipt or card statement showing you were there
• Your shoes and clothes, kept as they were
• Medical records starting the same day, if possible
• A written note of what happened, while you remember it

Sample video preservation letter

A letter asking the business to keep its video and records. Send it as soon as you can, by a method you can prove (such as certified mail and email), and keep a copy.

[Date]

[Store name]
Attn: Store Manager / Risk Management
[Store address]

Re: Request to preserve evidence
Incident date and time: [date], about [time]
Location in store: [aisle / entrance / department]
Person injured: [your name]

Please preserve all evidence related to the incident above, including:

1. All video from every camera that shows the area of the incident,
   the entrances, and the surrounding aisles, from [2 hours before]
   to [1 hour after] the incident.
2. Floor inspection, sweep, or cleaning logs for that day.
3. Incident reports, photographs, and written or recorded
   statements by employees or witnesses.
4. Names of employees working in that area during that time.
5. Any maintenance or repair records for the area.

Please do not delete, record over, or discard any of these items.

Sincerely,
[Your name]
[Phone] [Email]