[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-171558-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-171558-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","witness-statement-template-statement-of-name-of-witness","Witness Statement Template - Statement of [name of witness]","","Witness Statement Template provides a structured statement format for individuals completing a case-related witness account. It guides the writer to document identity and professional qualifications, explain purpose and available resources, outline current role and involvement in patient care, and describe diagnosis context and ward/team background. A chronological narrative must use first-person active wording, clarify contemporaneous records, define abbreviations, quantify details, state shift timing and attendees, and note uncertainty. The template concludes with a statement of truth, signature, and attachments, while specifying layout and formatting requirements.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/letters/","Letters",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/witness-statement-template-statement-of-name-of-witness/171558/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/witness-statement-template-statement-of-name-of-witness/171558.png","ImageObject",442,249,{"name":42,"@type":43},"Oliver","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-10-19","2026-09-01",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",6,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What information should a witness include at the start of the statement?","Question",{"text":63,"@type":64},"Include the witness’s name and professional address, professional qualifications (including the date qualified), and identify the person/role requesting the statement. Include the statement date and a statement number.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How should the witness describe involvement in chronological order?",{"text":68,"@type":64},"Provide a story of involvement in chronological order and use first-person singular in active voice (e.g., “I intubated…”). Add sub-headings where appropriate and ensure clarity for a lay reader.",{"name":70,"@type":61,"acceptedAnswer":71},"What requirements apply when clarifying medical records and using medical terminology?",{"text":72,"@type":64},"Access medical records to clarify ambiguity in the contemporaneous record. Specify exact wording, quantify descriptions where needed, explain abbreviations and jargon, and fully record actions and advice given. Clearly state if the witness cannot remember something.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},171558,1788284140,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,114,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},17,"Forms",40,"forms",{"id":115,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":116,"slug":117},18,30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":115,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":121,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":80,"read_time":26},8796095461610,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Witness Statement Template\nStatement of [name of witness] for [name or role of person requesting statement, for example, case manager or coroner]\nDate\nStatement Number 1\nName and professional address\nProfessional Qualifications\n1. This can, in most cases, be limited to one or two paragraphs.  A fuller curriculum vitae can be added as an appendix if appropriate.  Specify the date you qualified.\nPurpose\n2. Why you are writing the statement\nResources\n3. What documents and records you had access to when writing the statement\nCurrent job title\n4.  What is your current job title and how long have you held this?\nAlso include when you started working at your organisation.\nProfessional role\n5. What does your role involve on a day to day basis.\nProfessional involvement\n6. Your involvement in the treatment/management of the patient.\nHow you know the patient and how long you’ve known them.\nBackground and context\n7. What does the patient’s diagnosis mean? Describe the treatment administered/surgery performed in general (not patient specific) terms.\n8. Explain the nature of the unit/ward/team and the patient group that you work with.  If it is a ward set out its size and the type of patients on the ward.\n9. Give details of your role on the ward or team.  For example, are you a manager? Or if you are under supervision, say by whom.\n10. Throughout the document, when referring to others, use their name and job title.\nChronology\n11. Provide a story of your involvement in chronological order.\n12. Use the first person singular (I intubated Mrs Brown), rather than the passive voice (Mrs Brown was intubated)\n13. You will need access to the medical records in order to write this section. This is because your task is to clarify any ambiguity in the contemporaneous record. Specifically:\nall contemporaneous opinion words need to be clarified.  For example, if your note says ‘patient used abusive language’ – you will need to specify exactly what words were used.  If the records says ‘there was a considerable quantity of pus’ – you will need to quantify how much there was.\nWhere you have only described half of what you did, you will need to provide a full record.  For example if the , ‘head injury advice given’ – you will need to specify exactly what you said.  Patient reassured – you will need to specify how you reassured the patient and how the patient responded.\nYou will also need to explain all abbreviations and jargon used in the contemporaneous record.\n14. Say when you started and finished your shift.\n15. Say who else was present at any given time.\n16. Sub-headings may be appropriate.\n17. If you can’t remember something, say so.\n18. Do not assume the reader has a medical background nor any knowledge of hospital routines. An intelligent lay person should be able to understand the content.\n19. When mentioning a drug explain what type it is, (for example anti depressant) and give its full name, dosage and route of administration.\n20. If normal procedures were not followed, set out what the normal procedures are and why they were not followed in this instance.\n21. When describing tasks that are covered by protocol stipulate which protocol and attach a copy to your statement.\n22. Would a photograph or plan of the ward/theatre/recovery room help the reader understand what happened?\n10. Statement of truth\n23. This statement is true to the best of my knowledge and belief.\n11. Signature\n12. Attachments\nFormat Guidelines\nStatements should:\nBe double spaced\nBe on one side of the paper only\nHave decent margins (on both side of the text) of at least 2.5 cms\nBound in a manner which does not inhibit photocopying and filing\nBe paginated and have numbered paragraphs\nHave headings and subheadings\nHave font size of at least 12\nHave short paragraphs; no more than 3 sentences per paragraph.  A sentence which exceeds two lines is probably too long\nHave attachments; policies, maps, photos and guidance documents\nBe typed","cbCainZesRNf3Lr9","https://ap.wps.com/l/cbCainZesRNf3Lr9","docx",60766,"English","# Witness information\n## Name, address, and professional qualifications\n## Purpose and resources\n# Professional role and patient context\n## Current job title and duration\n## Day-to-day responsibilities and involvement\n## Background, context, and diagnosis meaning\n# Chronology and narrative requirements\n## Chronological story of involvement\n## First-person active voice and record clarification\n## Shift timing, attendees, and uncertainty\n## Drugs, protocols, and supporting materials\n# Statement of truth and final details\n## Statement of truth and signature\n## Attachments and format guidelines","[{\"question\":\"What information should a witness include at the start of the statement?\",\"answer\":\"Include the witness’s name and professional address, professional qualifications (including the date qualified), and identify the person/role requesting the statement. Include the statement date and a statement number.\"},{\"question\":\"How should the witness describe involvement in chronological order?\",\"answer\":\"Provide a story of involvement in chronological order and use first-person singular in active voice (e.g., “I intubated…”). Add sub-headings where appropriate and ensure clarity for a lay reader.\"},{\"question\":\"What requirements apply when clarifying medical records and using medical terminology?\",\"answer\":\"Access medical records to clarify ambiguity in the contemporaneous record. Specify exact wording, quantify descriptions where needed, explain abbreviations and jargon, and fully record actions and advice given. Clearly state if the witness cannot remember something.\"}]","Witness Statement Template - Statement of [name of witness] | DOCX"]