G&H Claims Professionals

Independent Claim Service Professionals & OSHA Certified Risk Management Specialists

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Online Assignment Form - Police/Accident Report Only




Below is a Form to submit assignments pertaining to retrieval of Police/Accident Reports only. All assignments are acknowledged within 24 hours of receipt. If an Acknowledgement is not received within 24 business hours, please contact Office Manager, Tracie Mattox, at 800-300-5435. G&H Claims Professionals sincerely appreciates your business!

Company Contact Name
Company Claim/Policy #
Company Name & Contact Information
Date of Loss
Loss Location
County of Loss
Accident Report #, if known
Insured Name
Insured Driver
Insured Address
Claimant Driver
Other Drivers Involved
Additional Instructions/Comments
Office Use Only - Police Report Only

Independent Claims Service Professionals & OSHA Certified Risk Management Services