Get Auto Accident Questionnaire - Dr Brian Gotro

Completing the Auto Accident Questionnaire - Dr Brian Gotro is an important step in documenting the details of your accident. This guide will provide you with straightforward instructions on how to accurately fill out each section of the form online, ensuring that all necessary information is gathered effectively.

Follow the steps to complete the questionnaire easily.

1. Click the ‘Get Form’ button to access the questionnaire and open it in your online editor.
2. Start by entering your name, date, and medical record number in the designated fields at the top of the form.
3. Fill in the date and time of the accident, specifying AM or PM as necessary.
4. Indicate who was driving your car, and provide details about where you were seated during the accident by selecting the appropriate options.
5. Specify the owner of the vehicle and input the year and model of both your car and the other vehicle involved.
6. Describe the extent of damage to your vehicle in dollar amounts and assess the visibility and road conditions at the time of the incident.
7. Indicate where your car was struck and select the type of accident that applies from the provided options.
8. Reflect on the impact by recalling any parts of your body that hit the inside of your car and whether you saw the accident coming.
9. Answer questions regarding your actions before the impact, such as whether you braced for the crash and if safety restraints were used.
10. Detail your car's motion at the time of the accident, including speed estimates for both vehicles, and assess your head and body position.
11. Provide information on your physical condition following the accident, including mobility and any injuries sustained.
12. Report how you felt immediately after the accident and later on, and check any symptoms you've experienced since the incident.
13. Indicate if you missed any work due to the accident and provide details regarding your medical treatment and history.
14. If applicable, provide information about any attorney involved in your claim and details of your insurance coverage.
15. Review all filled details for accuracy before finalizing the form. You may then save your changes, download a copy, print it, or share it as needed.

Complete your Auto Accident Questionnaire online today to ensure all necessary details are documented.