Get Intake Form- Wrongful Death

Filling out the Intake Form for a wrongful death case is an important step in the legal process. This guide provides clear, step-by-step instructions to help you accurately complete the form online, ensuring that your information is thorough and precise.

Follow the steps to successfully complete the Intake Form.

1. Press the ‘Get Form’ button to acquire the Intake Form for wrongful death and open it in your preferred document editor.
2. Enter the date of the incident in the designated field. Make sure to provide the exact date to avoid any discrepancies.
3. Fill in the time of the incident accurately. This information is crucial for understanding the context of the case.
4. Provide your full name as it appears on official documents.
5. Indicate today’s date, ensuring the information is current.
6. Complete your street address, including any necessary details such as apartment or unit numbers.
7. Input the name of your spouse or partner, if applicable.
8. Fill in your city, state, and ZIP code.
9. Enter your Social Security number, as this will assist in identifying your records.
10. Provide your home phone number for communication purposes.
11. Indicate your date of birth.
12. If applicable, fill in your work phone number.
13. Complete your age.
14. Add your cell phone number for additional contact.
15. List how you were referred to the firm.
16. Provide the information for the proposed personal representative, including their name, address, phone number, Social Security number, and date of birth.
17. Answer whether you have ever been convicted of a felony, providing details if necessary.
18. Answer whether you have ever filed a petition for bankruptcy and provide details if applicable.
19. Complete the sections for the proposed co-personal representative in the same manner as the previous representative.
20. Fill in the decedent's information, including name, address, date of birth, Social Security Number, marital status, county of residence, date of occurrence, and date of death.
21. If applicable, provide details of the deceased’s auto insurance and health insurance.
22. List pertinent details regarding the negligent party, including their name, address, and insurance information.
23. Provide a brief description of the accident and any relevant witness information.
24. Once all fields are completed, review your entries for accuracy, then save your changes, download, print, or share the form as needed.

Complete your Intake Form online today to initiate the process.