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Were you or a loved one injured in accident that was not your fault? No Yes

Were you treated by a Medical Professional? No Yes

Did the accident require hospitalization or medical treatment? No Yes

Do you currently have a lawyer representing your injury claim? No Yes

What type of accident occurred? Auto Accident Motorcycle Accident Truck Accident Medical Malpractice Work Injury Slip and Fall Product Liability Dog Bite

What was the date of your accident?