Chevron pointing to the right, indicating forward movement.

Free Personal Injury Questionnaire Template – Download Now

Get a free Personal Injury Questionnaire Template to document accident details, medical treatment, and financial losses for your personal injury claim.

Free Download

A Personal Injury Questionnaire is a valuable template for documenting injuries, medical treatment, and financial losses after an accident. This form helps lawyers, insurance companies, and injured individuals collect crucial details for a personal injury claim.

Why Use a Personal Injury Questionnaire?

This questionnaire ensures that all important information is recorded, including:

Accident details – date, location, parties involved, and how it happened.

Injury description – symptoms, severity, and long-term effects.

Medical treatment – doctors seen, treatments received, and medical expenses.

Work impact – lost wages and work time off due to injuries.

Insurance and legal information – witness details and policy coverage.

Who Can Use This Personal Injury Questionnaire Form?

Injured individuals preparing to file a personal injury claim.

Lawyers gathering evidence for a case.

Insurance adjusters assessing claims.

How to Use This Template

Download the free template by typing in your email address in this page.

Get the template directly in your inbox.

Fill out all sections with accurate details about the accident and injuries.

Share with your attorney or insurance company to support your claim.

Related Guides

Request for Factual Correction of an Unrepresented Panel QME Report (QME Form 37)

Download the QME Form 37 template to request factual corrections to an unrepresented panel QME report in California workers' compensation cases. Get it free now!

Free Download