Personal Injury Intake

Tell us what happened. There are strict time limits for injury claims, so please include the date.

Your full name (required)Date of birth (required)Email address (required)Phone number (required)Address (required)

The incident

When did it happen? (required)What kind of incident? (required)Where did it happen? (required)What happened? (required)Who do you think was responsible, and why? (required)Was it reported at the time? (required)Any reference or crime numberWere there witnesses? (required)

Your injuries

What injuries did you suffer? (required)Where were you treated? (required)Are you still affected? (required)Did you have time off work? (required)Any costs or losses so far?

Claim and funding

Have you made an injury claim before? (required)Do you have legal expenses insurance? (required)Have you spoken to other solicitors about this? (required)

I understand there are strict time limits for making a claim (required)