Tremblay & Smith, PLLC

Personal Injury & Malpractice, Domestic & Family Law, Corporate & Business Law

Details of Your Legal Matter

What was the date of the accident?
Were you a passanger or the driver?
Passanger Driver
Please provide a brief description of the accident
Are you the owner of the vehicle?
Yes No
If you are the owner of the vehicle, does your automobile insurance limit uninsured motorist coverage?
Yes No Not sure
If you are the owner of the vehicle, does your automobile insurance limit medical payment benefits?
Yes No Not sure
Did you file a claim?
Yes No
Was a police report filed?
Yes No Not sure
Were there any witnesses?
Yes No Not sure
If yes, do you know how to contact these witnesses?
Yes No
Were you injured?
Yes No
If yes, were you taken to the hospital by ambulance?
Yes No
Were you treated in an emergency room?
Yes No
Were you employed at the time of the accident?
Yes No
If yes, has a worker\\\\\\\'s compensation claim been opened?
Yes No
Have you been involved in an accident before?
Yes No
Details

General Info

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