Most personal injury intake forms used by new solos and small firms are missing the same five things. They capture the client’s name, the date of the accident, and a one-line description of injuries — then the file gets opened and the same questions get re-asked on the call. Critical information falls through: subrogation rights, prior claims to the same body part, witness contact details that decay within days of the accident.
A well-built intake captures everything needed to evaluate the case, run the conflict check, and start the file before the client ever picks up the phone. Eleven sections separate a complete intake from a placeholder.
1. Contact information beyond the obvious
Name, address, date of birth, phone, email, preferred contact method — fine. Add an emergency contact who isn’t a co-witness or co-passenger. PI matters have unforgiving deadlines; redundant ways to reach the client matter when the case turns on a missed phone call.
2. Accident details, locked-down to specifics
Date, time, exact location (street and cross-street, county, state), weather, road conditions. “Highway” is not a location — the venue analysis depends on the county. Direction of travel for every vehicle involved. Surface conditions at the time, not at the time of intake.
3. Every party to the incident
Driver and passenger of every vehicle. Every witness. Every pedestrian. Full names, addresses, phone numbers, and insurance carriers where known. License plates if the client wrote them down. Most intakes shortchange this section; most cases turn on what’s recorded here.
4. Police and emergency response
Police report number, responding officer’s name and department, hospital or ambulance company, ER and admission times. The police report often answers half the initial investigative questions. The ambulance run sheet usually contains pre-litigation statements the defense will pull on subpoena.
5. Injuries in the client’s own words
Not the medical record version. What hurts, what the client couldn’t do and for how long, what they still can’t do. This becomes the damages narrative; sanitizing it now removes the texture later.
6. Medical treatment, past and projected
Every provider seen since the accident, with dates and reason for the visit. Pre-accident treatment for the same body part — yes, ask, because the defense will find it whether asked or not. Current treatment status. Recommended future care from any treating provider.
7. Employment and wage loss
Employer, position, hourly or salary, average hours, days missed, return-to-work status. Approximately half of damages in most PI matters; treat the section with the precision it deserves.
8. Property damage and loss payees
Total loss or repair amount, who paid, who’s named as loss payee. Subrogation lien analysis begins with this section.
9. Insurance coverage in every direction
Client’s auto policy with limits. Health insurance (because subrogation, ERISA, Medicare, and Medicaid lien rules differ). Medical pay or PIP coverage. Underinsured and uninsured coverage from every household policy. The defendant’s carrier if known. Each of these affects valuation; missing any of them can mean settlement at the wrong number.
10. Prior claims, suits, and bankruptcies
The credibility section. Prior injury claims to the same body part will be discoverable. Bankruptcy filings that didn’t list a potential claim as an asset will be uncovered. Ask once, document precisely. Don’t get surprised at deposition.
11. Liens and assignments already signed
Has the client signed anything in the ER giving a hospital a lien? Has health insurance already paid bills that create subrogation exposure? Has the client signed with a lien funding company? Settlement negotiations require knowing what’s already encumbered.
Where most intakes go wrong
Combining intake with authorization. Best practice splits the two: an internal intake (firm work product, no client signatures) and a separate client questionnaire that includes HIPAA authorizations, medical records release, and engagement signatures. The intake holds the litigation strategy notes; the questionnaire is the document that gets produced or referenced in discovery.
Date fields not time-stamped. Statute of limitations runs from the date of injury for most causes — but not all. Discovery rules toll. Tolling for minors and incapacitated plaintiffs varies by jurisdiction. Some claims accrue at discovery, not at injury. Document every relevant date on the intake itself, including the deadline calculation.
No social media inquiry. Every modern PI case begins with the defense investigator pulling the client’s Instagram. The intake should ask about active social accounts on day one so preservation and avoidance counsel can happen before something gets posted that hurts the case.
A professional starting point
Templateez offers a personal injury intake form set built on a clean litigation-format structure — case administration, client information, opposing party, matter narrative, key dates, court details, case stage, opposing counsel, claims and legal theories, witnesses, and a progress log on the intake side, plus a 2-page client questionnaire covering background, damages, and goals. The set is $19.99.
View the Personal Injury Intake Form Set →
The framework above is the standard for what a complete PI intake should capture. Use the Templateez set as your professional baseline and extend it with the accident-specific, insurance, and lien-tracking sections your practice handles most often.