Published November 28, 2025
Auto Accident Medical Treatment Log PDF (Free Template)
After a crash, insurers want a clear record of treatment and costs. Use this log to track providers, visit reasons, out-of-pocket payments, and insurance reimbursements. It keeps your claim organized but is not legal advice.
Why tracking treatment matters for accident claims
Adjusters review visit dates, providers, billed amounts, and payments when evaluating liability and medical damages. A tidy log reduces back-and-forth and helps your attorney or insurer see what is still outstanding.
What to record
- Each appointment date and provider name (clinic, hospital, therapist, chiropractor).
- Reason for the visit and the treatment or test performed.
- Out-of-pocket costs you paid and amounts the insurer covered.
- Notes about authorizations, denials, or follow-up referrals.
- Claim and adjuster information so the PDF is ready to share.
How to use the free CourtPDF tool
- Enter the claimant name, claim number, insurer, adjuster, and accident date.
- List each treatment with the date, provider, reason, and treatment type.
- Add out-of-pocket costs and insurance payments to total everything automatically.
- Download the PDF log and keep it with receipts, EOBs, and medical reports.
Disclaimer
This log is for record-keeping and organization. It does not replace legal advice. Talk with an attorney or adjuster about your claim requirements.