Get General Intake Form

Completing the General Intake Form online is a crucial step in ensuring that your information is accurately captured. This guide will help you navigate each section of the form with clarity and ease.

Follow the steps to complete the form seamlessly.

1. Click ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin by entering the date of the incident in the designated field. Ensure that the date is accurate to maintain the integrity of your submission.
3. Provide your Social Security Number (SSN) and driver’s license number in their respective fields. These identifiers are essential for your record.
4. Indicate whether you have consulted with any other attorneys regarding this accident or injury. If yes, list their names and the actions taken.
5. Fill in your personal information, including your name, address, birth date, age, sex, and contact information. Make certain all details are correct to avoid issues later.
6. In the accident information section, record the date of the incident and whether a police report was filed. Include details about the accident location and the other driver involved.
7. List any witnesses with their names, addresses, and phone numbers. This information can be vital for your case.
8. Detail your injuries, specifying the parts of the body that were harmed. Answer whether you have been released from treatment and if you experienced any wage loss due to your injuries.
9. Document your treating doctors by providing their names, addresses, the body parts treated, and dates of treatment. Mention any surgeries or discussions regarding surgeries resulting from your injuries.
10. Honesty is crucial in the prior injuries or disabilities section. List all past injuries, disabilities, or impairments, including those from military service.
11. Fill out your insurance information, including the other driver’s insurance company, adjuster’s details, and any uninsured motorist coverage you may have.
12. Provide information regarding how you were referred to the office and complete any additional fields as prompted.
13. Once you have filled out all necessary sections, review your entries for accuracy. After ensuring all information is correct, save your changes, download the form, or share it as needed.

Start completing your documents online today to ensure a smooth process.