Florida Personal Injury Intake Sheet

State:
Multi-State
Control #:
US-PI-0003
Format:
Word; 
Rich Text
Instant download

Description

This assortment of forms are to be used by the attorney to assist in the collection of information regarding new clients. Among the forms included are interview forms, employment contract, various releases, and client instructions.

Florida Personal Injury Intake Sheet serves as a crucial document in the legal process that collects essential information from individuals who have suffered a personal injury in the state of Florida. The intake sheet helps personal injury attorneys and law firms gather pertinent details about the accident, injuries sustained, and necessary information to initiate and pursue a personal injury claim. The Florida Personal Injury Intake Sheet typically includes several sections covering various aspects of the incident and the injured party's information. It aims to provide a comprehensive overview to aid the attorney in formulating a strong legal strategy and representing the injured party effectively. Key sections contained within the Florida Personal Injury Intake Sheet include: 1. General Information: This segment collects basic details such as the client's full name, contact information, date of birth, and social security number. It also gathers information relevant to the case, such as the accident date, location, and a brief description of what happened. 2. Accident Details: Here, the intake sheet focuses on gathering specific information about the incident itself. It may ask about the parties involved, including any witnesses, their contact information, and statements. It also seeks information about law enforcement involvement, such as the responding officer's name and badge number, and if any citations were issued. 3. Insurance Information: This section pertains to insurance coverage, asking for the client's own insurance details, medicare/medicaid information (if applicable), and any details regarding the at-fault party's insurance policy. 4. Medical Treatment: This part requires the injured party to describe the medical treatment received, including hospital visits, specialists consulted, medications prescribed, and any ongoing therapy or rehabilitation programs. It may also request information concerning pre-existing conditions that may have been aggravated due to the accident. 5. Damages and Losses: Here, the intake sheet seeks information related to the damages and losses suffered by the client. This may include property damage, medical expenses incurred, lost wages, pain and suffering, emotional distress, and any other relevant financial losses as a result of the accident. Additionally, while not separate types of intake sheets, specific variations may exist based on the type of personal injury case. These may include: — Motor Vehicle Accident Intake Sheet: Specifically designed for individuals injured in car accidents, it may gather additional information such as vehicle details, insurance policies, police report information, and accident-specific details. — Slip and Fall Intake Sheet: Tailored for individuals injured due to slip and fall incidents, this variation may focus on premises liability, unsafe conditions, and other relevant factors pertaining to the fall. — Medical Malpractice Intake Sheet: For individuals who have suffered harm due to medical negligence or malpractice. This intake sheet may delve into medical history, the standard of care breached, and specific details about the alleged malpractice incident. These variations provide the attorney with case-specific details to build a strong legal argument and properly assess the nature and extent of the injury sustained. The Florida Personal Injury Intake Sheet, in its various forms, plays a vital role in ensuring that the legal representation receives all essential information required to pursue a successful personal injury claim on behalf of the injured party.

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FAQ

PIP insurance covers you and any relatives residing in your household for injuries sustained in an automobile accident regardless of who is at fault. This coverage pays 80% of reasonable and necessary medical bills and 60% of lost wages.

In 2021, the Florida Senate introduced SB 54, which would eliminate the mandatory PIP requirement for auto insurance. In its place, the new PIP reform law would require vehicle owners to carry: A minimum of $25,000 in bodily injury coverage. A minimum of $50,000 for two or more people in any one accident.

As per section 95.11 (3) (a) of the Florida Statute of Limitations, the statute of limitations to file your claim for personal injury in Florida typically ranges from 2-5 years from the date of your injury depending on the claim type.

Under the new law, most personal injury lawsuits must be filed within two years of the date of injury, or they will not be allowed. Florida already had a two-year statute of limitations on medical malpractice and wrongful death lawsuits.

Drivers must be insured with PIP coverage in Florida and property damage liability (PDL) at the time of vehicle registration. Drivers must have a minimum of $10,000 in PIP and a minimum of $10,000 in PDL.

One of the biggest changes in the 2023 personal injury law bill was the new requirement of a Letter of Protection disclosure. A Letter of Protection in Florida is an agreement between medical providers and patients to wait to pay a bill using the proceeds of a legal settlement.

PIP insurance pays 80% of crash-related medical costs, up to the $10,000 PIP limit per covered person, for things like ambulance rides, hospital bills, doctor visits, dental work and more. You must receive initial care within 14 days of an accident for medical expenses to be covered.

The New Tort Reform and Florida's Comparative Negligence Under the new modified comparative negligence system in Florida, individuals will be barred from compensation recovery if they are more than 50% responsible for causing their own injuries.

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If you are the person providing the documentation, filling out the form below will prepare you for most of the questions these individuals need answered. ... a list of general instructions that will require your attention. In completing this intake sheet, have you thought of any information which I have not asked ...Are you under the care of a physician now? ___ Yes ____ No. Did you miss ... Describe the injury: ... Jun 9, 2018 — Please complete one of the forms below – someone from our office will contact you within 24-48 hours to discuss next steps! Personal Accident ... For your convenience we have provided intake forms that you can fill in to give us a better understanding about your case. Personal Injury Intake Form ... Describe your injury(ies). ... Total medical expenses incurred to date : ! Total medical expenses you expect : Attorney Advertising. This website is designed for ... Client Intake Forms · Conflict of Interest Search Form · Initial Client Consultation Interview Form · Initial Contact Report · New Matter Report · New Matter ... Oct 18, 2016 — After your free consultation with a personal injury attorney, you may decide that you are ready to retain them as your lawyer. Fill out the form below (Click here for the printable version that can be filled out and brought in). Step 2.) If you have not yet, call the office to schedule ... Jun 2, 2022 — General Personal Injury Intake Form for the Gorospe Law Group personal injury attorney law firm in Tulsa, Oklahoma.

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Florida Personal Injury Intake Sheet