INCIDENT REPORT FORM

At Chalmers, we understand that youth-serving organizations like yours are dedicated to creating safe, enriching environments for young people. However, we also recognize that unforeseen events can occur. When bad things happen, our commitment to you is unwavering.

We are here to provide not just insurance coverage, but the support and guidance needed to navigate challenging times. As a family-owned agency, we stand by you, so that even in the toughest moments, you can continue your vital work with the assurance that we’ve got your back.

IMPORTANT DISCLOSURE REGARDING CLAIM SUBMISSION

Please note that your claim is not considered submitted until you receive a confirmation from our team. We may need to contact you to request additional information in order to proceed with processing your claim.

Submitting this form through electronic means does not constitute an official report of loss. Instead, it serves as a convenient way to notify us that you require assistance with a potential claim.