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Personal injury intake form template

NEW CLIENT INTAKE - PERSONAL INJURY 2026

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The document is a comprehensive client intake form for personal injury cases, requiring detailed personal and accident-related information from the client. It emphasizes the importance of accuracy and completeness to ensure effective legal representation, covering aspects such as personal details, accident specifics, medical treatment, injuries, insurance information, and any prior accidents or injuries.

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Click ‘Get Form’ to open the NEW CLIENT INTAKE - PERSONAL INJURY document in the editor.
Begin by entering today's date at the top of the form. This helps establish a timeline for your case.
Fill in your personal information, including your name, age, birthdate, and Social Security Number. Ensure accuracy as this information is crucial for representation.
Provide your contact details such as street address, city, state, zip code, phone number, and email. This ensures that you can be reached easily throughout the process.
Detail your employment information including employer's name, job title, and address. Include how long you've been employed and your hourly wage.
In the section regarding the accident, describe what happened in detail. Include names, dates, times, and locations to provide a comprehensive account.
List any witnesses who can support your claim and detail any medical treatment you sought post-accident.
Complete sections on injuries sustained and any restrictions on work or activities due to the accident. Be candid for accurate representation.
Finally, review all entries for completeness before saving or submitting the form through our platform.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is personal injury intake?

The personal injury intake process begins before any medical treatment occurs. The goal is to quickly assess important information, such as the incident, injury severity, liability, and available insurance coverage. This helps attorneys determine if a case is worth pursuingand how to best allocate resources.

What is the initial client intake?

Client intake refers to the process of introducing a potential new client to your law firm. Through a series of steps, legal professionals collect relevant client information, assess whether theyre a good fit, conduct conflict checks, and successfully onboard them.

What should be on a client intake form?

So, what information does the client intake form gather? It can range from basic contact details to nuanced preferences and requirements. Client intake forms, especially digital intake forms, can also collect information on their internal processes.

What does a personal injury intake specialist do?

Your personal injury intake specialist will collect client and case details, including personal information, known contacts, and all facts about the injury and its causes. The specialist will also document and organize this information so the legal team has easy access.

What does personal injury coverage cover?

Personal injury protection (PIP), also known as no-fault insurance, covers medical expenses and lost wages for you and your passengers if youre injured in an accident. PIP coverage protects you regardless of whos at fault.

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What is included in the client intake process?

New client intake generally involves collection of new clients basic information, contact information or their needs and desires. It frequently require paperwork, questionnaires and an initial consultation. This whole process enables organizations to better understand their clients, staff and improve services.

What is considered to be a personal injury?

Personal injury in law is the legal term used to describe harm inflicted upon an individual, whether it be physical, mental, or emotional, due to the negligence or intentional actions of another person or entity. In essence, it encompasses a broad range of situations where an individual suffers harm.

How much do you get for a personal injury claim?

The honest answer is that each claim is unique, so your legal team wont be able to give you an exact figure until they know more about your case. How much compensation you could get for personal injury will depend on factors such as: The type and severity of your injuries. Your recovery time following the incident.