Attorneys

What type of injuries do you have?

Auto/Motor Vehicle Accident
Slip and fall
Dog bite
Railroad accident
Wrongful death
Hurt on the job
Other

What is the extent of your injuries?

Have you seen a doctor?

Yes
No

What are your medical bills?

Have you filed any claims?

Yes
No

Have you filed a police report?

Yes
No

Were there any witnesses?

Yes
No

Do you have insurance that covers you for this type of incident?

Yes
No
Not Sure

Do other involved parties have insurance that covers this type of incident?

Yes
No
Not sure

Please describe how you were injured.

Have you been arrested?

Yes
No

Have you been arraigned?

Yes
No

Have you been questioned by the police?

Yes
No

Do you have a court appearance scheduled?

Yes
No

If so what is the date?

Are you currently represented by another attorney?

Yes
No

Please describe the situation and your involvement:

What crime have you been charged with?

eg. xxx-xxx-xxxx

* Please explain your legal situation.