Question 1 of 8
What type of incident were you involved in?
Car accident
Truck accident
Motorcycle accident
Slip and fall
Dog bite
Workplace injury
Other
Question 2 of 8
Were you injured?
Question 3 of 8
Did someone else appear to be at fault?
Question 4 of 8
Did you seek medical care?
Emergency Room (ER)
Urgent Care
Doctor
Not Yet
Question 5 of 8
Is there a police or incident report?
Question 6 of 8
Are you currently dealing with pain, medical bills, or lost wages?
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