Truck Accidents Contact Form

Name

Email Address

Phone Number

Were you or a loved one the victim of an accident involving a commercial truck?
Yes No 

If the victim was a loved one, what is your relationship with that person?

When and where did the accident occur?

Were you or your loved one a passenger, driver, or pedestrian?
Yes No 

How did the accident occur? Describe what happened.

What kind of truck was involved?

Do you know the name of the driver?
Yes No 

His or her trucking company?
Yes No 

His or her employer?
Yes No 

Was a police report generated by the accident?
Yes No 

Do you know if any traffic citations were issued?
Yes No 

Do you know the names of any witnesses to the accident?
Yes No 

What injuries were sustained as a result of the accident?

Did you seek and are you currently receiving medical treatment as a result of the accident?
Yes No 

What is your prognosis?

Have you discussed this matter with your own insurance representative?
Yes No 

Have you discussed this matter with any insurance representative or attorney representing other parties involved in the accident?
Yes No 

How has this accident affected your overall quality of life and well-being?

DISCLAIMER: This site and any information contained herein are intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.