Intake for Counsel Your legal care team is waiting... Let’s start with a few questions about you and your injury so we can get you the help you need. How were you injured? How were you injured? Car Accident Truck Accident Pedestrian Accident Other Sorry to hear about your accident. Who was injured? Who was injured? I was injured A loved one was injured We were both injured No one was injured Which state did the injury happen in? Which state did the injury happen in? Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming District of Columbia American Samoa Guam Northern Mariana Islands Puerto Rico U.S. Virgin Islands When did the accident happen? When did the accident happen? Were you or the injured party treated for injuries? Were you or the injured party treated for injuries? Treated at a hospital Treated at a doctor's office Not treated Other Can you describe the injury? Can you describe the injury? Head injury Back or neck Body injury Anxiety or emotional injury Death Other injury What was the injured persons role in the accident? What was the injured persons role in the accident? Driver Passenger Pedestrian Cyclist Other What type of accident was it? What type of accident was it? Someone else hit us We hit someone else Single car Other Who was at fault? Who was at fault? Us The other party Not determined Have you spoken to a lawyer about your accident? Have you spoken to a lawyer about your accident? Yes No We were but not anymore If yes, Did you retain a lawyer already? If yes, Did you retain a lawyer already? Yes No One more thing... Fill out the info below so we can start assembling your personal legal care team. First Name Last Name Mobile Number Email Address Injured party name Anything else we should know? Submit