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AUTO ACCIDENT INJURY

Hi there, Law Office of Joshua Y. Lee is using this new system for your convenience.  If you have recently been in an automobile, motorcycle, or other vehicle related accident please fill out and submit this form.  It is important you provide us all the information you have.  The more info we have the better we can serve you.  (IMPORTANT: We are not your attorneys unless and until you sign a fee agreement with our firm.  This intake form only gives us background information and is not to be interpreted as having hired our firm nor our acceptance of any matter or client.  Such a relationship does not exist as of the filling of the form below.)  Upon completion someone will get back to you within a few hours to a few days.
51Questions
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    In order to provide our clients with efficient and convenient legal services, our law office will communicate and transmit documents using e-mail, social media, cell phone, text messages, internet and web and fax.  Because cybersecurity and technology as a whole continues to evolve, there may be risks communicating in these manners, including risks related to confidentiality and security and those associated with being hacked.  By entering the information on this form, you are consenting to such e-mail, social media, cell phone, internet, zoom, web and fax communications.   You are also acknowledging the risks and accepting them.  In addition, our law office uses Drop-box and other cloud based technologies and services with servers located in facilities outside of our office.  Most of our electronic data, emails, and documents are stored in this manner.  By entering the information on this form, you understand and consent to having communications and documents pertinent to your Matter stored and handled in this cloud based manner.  Because technology continues to evolve, there are risks, as already discussed above.  By filling out your name and putting your initials below, you knowingly, intelligently consent to everything in this paragraph.
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    Please give name and contact info of the person / attorney or website and contact info.
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    Necessary for settlement purposes 
    • Unmarried
    • Married
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    If Married
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    Please Select
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    Address, cross streets, or other approximate location identifier
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    Helps determine damages and other liability
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    Helps determine damages and other liability
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    Helps determine damages and other liability and helps us find local medical treatment for you
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    Address, cross streets, or other approximate location identifier
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    PM
    • AM
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    Mark all that apply
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    Mark all that apply
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    The car you were in
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    The car you were in
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    The other guy
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    Skip if only 2 cars involved
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    Insurance company, policy#, claim# (if any), Policy info, etc. auto and umbrella policy
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    Insurance company, policy#, claim#, contact info, insurance info, vehicle info
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    Other than damage to your vehicle describe if you had any other property damage including to carseats, if any, your clothing, sunglasses, cell phone, computer, etc?
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    Mark all that apply
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    Mark all that apply
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    What, when, where, how, why
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    Skip if not car accident otherwise select all that apply
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    Must check as many as apply
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    Driver's license, insurance cards, medical ins cards, Medi-Cal/Medicare, car damage, injuries, etc.
    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
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  • 44
    Skip if not car accident
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  • 45
    Everyone should fill out
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  • 46
    Everyone should fill out
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  • 47
    Everyone should fill out
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  • 48
    By clicking "Yes", you consent to and accept the risks involved with Zoom meetings, including those related to privacy. You must be in a private and quiet area without anybody else in the room during the meeting.
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PERSONAL INJURY (AUTO ACCIDENT)
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