Lawyer Client Intake Questionnaire for Personal Injury Claims

Lawyers can use this Intake Form to collect the information they need from a client to launch a personal injury case.


Scope of the Intake Questionnaire

The 24-page form contains numerous sections for information gathering, including:

  • personal details about the client, spouse/partner and children,
  • employment, education, community involvement,
  • military service,
  • hobbies and activities,
  • the accident / incident that resulted in the injury,
  • details about the injury, diagnosis, prognosis, treatment and ongoing effects,
  • medical expenses, vehicle repair costs, and other related costs,
  • insurance details for all vehicles involved,
  • medical history,
  • driving records,
  • criminal history,
  • a section for slip and fall injury claims.
  • Available in MS Word format and fully editable to fit your exact needs.

Format and Use

The Client Intake Questionnaire is available in MS Word format and is downloadable, fully editable and reusable as a template. It can be used anywhere.

Document Type: Microsoft Word
Last Updated: 02-April-2026
SKU: 3185
$11.99