Home

1. What is your full name?

2. What is your relationship to the victim?

3. What is the full name of the victim?

4. When did the accident occur? (Date and Time)

5. Where did the accident occur? (Location)

6. Describe the weather and road conditions at the time of the accident.

7. What type of vehicles were involved in the accident?

8. Describe the events leading up to the accident.

9. Describe the accident itself.

10. Were there any witnesses to the accident? If so, please provide their contact information.

11. Were the police called to the scene? If so, please provide the police report number.

12. Was anyone cited or arrested at the scene? If so, who and for what reason?

13. Describe the injuries sustained by the victim.

14. What medical treatment has the victim received so far?

15. Is the victim still receiving medical treatment? If so, please describe.

16. Has the victim missed work due to the accident? If so, how much time has been missed?

17. Has the victim experienced any emotional or psychological effects from the accident? If so, please describe.

18. Has the victim's vehicle been repaired or replaced? If so, please provide details.

19. Has the victim incurred any out-of-pocket expenses due to the accident? If so, please provide details.

20. Has the victim's insurance company been notified of the accident? If so, please provide the claim number.

21. Has the other party's insurance company been notified of the accident? If so, please provide the claim number.

22. Has the victim given any statements to insurance companies or investigators? If so, please provide details.

23. Has the victim signed any documents related to the accident? If so, please provide details.

24. Has the victim been contacted by any lawyers or legal representatives? If so, please provide details.

25. Is there any additional information that you believe is important for the lawyer to know?

Questionnaire