Risk Management Service

Online Loss Notification

Select the Type of Loss*
Name of Adventist site that suffered the loss:*
Name of Individual who suffered the loss:*
When did the loss happen?*

Day
Month
Year
Where did it happen?*
Country
International Address*
Street Address Address Line 2 City / Region
Address*
Street Address Address Line 2 Suburb Select State
Tell us what happened.*
Describe in detail what happened, time of incident, whether emergency services were involved, or if anyone witnessed the event.
Estimated value or cost of the loss?*
- Less than $5,000
- $5,000 or greater
- Unsure
If less than $5,000 please provide estimate:
An approximate dollar or 'best guess' value is acceptable.
Estimated value or cost of the loss?*
An approximate dollar or 'best guess' value is acceptable.
Contact Name for this loss:*
Contact Number*
Email Address*
Accept Privacy Policy*
- I have read and accept the RMS Privacy Policy.
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