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The document is a Personal Injury Client Interview Form from Matthew D. Kaplan, LLC, designed to collect detailed information from clients involved in an accident. It includes sections for personal details, accident specifics, vehicle information, injuries sustained, wage loss due to the accident, and previous medical history. The form emphasizes the importance of thorough and accurate responses to aid in the client's case.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the 'DATE OF ACCIDENT' and your 'NAME' in the designated fields. Ensure accuracy as this information is crucial for your case.
Fill in your contact details, including 'STREET ADDRESS', 'CITY, STATE, ZIP CODE', and phone numbers. This helps maintain clear communication.
Provide details about the accident such as 'TIME OF ACCIDENT' and 'DESCRIPTION OF VEHICLE'. Be thorough to ensure all relevant information is captured.
In the 'ACCIDENT INFORMATION' section, describe how the accident occurred and include any witnesses. Use the diagram tool to illustrate the scene if necessary.
Complete the 'INJURIES' section by indicating any symptoms experienced post-accident. This will assist in documenting your medical needs.
Finally, review all entries for accuracy before submitting. Our platform allows you to save your progress at any time.

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