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Personal injury questionnaire

personal injury questionnaire

Looking to streamline your personal injury case intake process? This questionnaire is perfect for law firms, attorneys, and lawyers who specialize in personal injury law.

You can use it to quickly gather crucial information from potential clients, saving you both time and effort. It'll help you assess the case's viability, understand the incident in detail, and calculate potential damages - all in one go.

Get ready to take your client onboarding to the next level!

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Questions to include on your Personal injury questionnaire

1. Claimant Information

It's crucial to gather the claimant's essential contact information and some personal details.

  • What is your full name?
  • What is your email address?
  • What is your contact number?
  • What is your date of birth?

2. Incident Details

The specifics about the incident are key to understanding the nature of the personal injury claim and the circumstances surrounding it.

  • When did the incident occur? (date and time)
  • Where did the incident take place?
  • Please provide a detailed description of the incident?
  • Were there any witnesses to the incident? (Yes/No)

The detailed description of the incident is critical as it allows the lawyer to understand the event and assess the potential claim.

3. Injury Information

This section probes into the nature and severity of the injury sustained, which will determine the potential compensation amount.

  • What type of injury did you sustain?
  • How severe is your injury? (Mild/Moderate/Severe)
  • Are your injuries permanent or temporary? (Permanent/Temporary)
  • Did you require hospitalization for your injury? (Yes/No)

4. Medical Treatment

These questions will help determine the extent of the medical intervention required, which contributes significantly to the claim's value.

  • Have you sought medical treatment for your injuries? (Yes/No)
  • If yes, please provide details of the medical treatment you received.
  • Are you still receiving treatment for your injuries? (Yes/No)

5. Financial Impact

These queries help ascertain the financial impact of the injury on the claimant and form the basis for compensation calculations.

  • Have you incurred any medical expenses due to the injury? (Yes/No)
  • If yes, please provide an estimate of your total medical expenses.
  • Have you lost any income due to your injury? (Yes/No)
  • If yes, please provide an estimate of your lost income.

Queries related to lost income and medical expenses allow the attorney to accurately calculate the economic damages for the case.

This section explores whether the claimant already has legal representation and who that might be.

  • Do you have legal representation for this claim? (Yes/No)
  • If yes, please provide the name of the law firm or attorney representing you.

Inquiring about existing legal representation allows the firm to avoid conflict of interest scenarios.

Things to consider

  1. Simplicity and Clarity - Make sure the questions are clear and straightforward. Avoid using complex legal jargon that might confuse the user.
  2. Form Layout - Organize the form logically. Group related questions together to make it easier to follow and complete.
  3. Accessibility - Ensure the form is accessible to people with disabilities by adhering to web accessibility standards. This may include using larger fonts, high contrast colors, and providing text alternatives for non-text content.
  4. Privacy and Security - Since the form will be handling sensitive personal data, it's essential to ensure the data is protected. Make sure you use a secure connection (HTTPS) and follow data protection laws.
  5. Mobile-Friendly - A significant number of users might access the form on their mobile devices. Therefore, ensure your form is responsive and provides a good user experience on smaller screens.
  6. Error Handling - If a user makes a mistake or misses a field, the form should clearly highlight the error and guide the user to correct it. This improves the overall user experience and ensures you collect accurate data.
  7. Providing Support - Include a contact method for users who have questions or encounter problems when filling out the form. This could be a phone number, email address, or even a live chat option.

How to create your Personal injury questionnaire

Now that you know what questions you should include, it's time to build your form!

The only problem is that traditional forms tools are inefficient.

People will forget to fill out your form. They'll get stuck halfway and not be able to finish it. Or they'll send you the wrong stuff. You end up wasting hours chasing people down over email. 

That's why you should give Content Snare a try. 

Content Snare is packed with advanced features that will have you hours:

  • Automatic reminders - Remind people to complete their form with fully customizable reminders.
  • Reject incorrect information - If a single question is filled out incorrectly, ask your client to re-do just that one item.
  • Autosaving - No progress gets lost. People can fill out forms in multiple sittings.
  • Comments and questions - If the person filling the form gets stuck, they can ask a question without having to email you.

Give it a go by signing up for your free 14-day trial

Get the information you need without chasing people

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