Transcription of PERSONAL INJURY - CLIENT INTERVIEW - …
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PERSONAL INJURY - CLIENT INTERVIEW - …
CLIENT information & INTERVIEW PERSONAL INJURY I. CLIENT information Name: _____ Address: _____ Home Phone: _____ Work Phone: _____ Car Phone: _____ Pager: _____ Date of Birth: _____ Social Security #: _____ Marital Status: _____ Number and Ages of Children: _____ Employer(s): _____ Employer(s) Address: _____ _____ _____ Job Title/Description: _____ Wage/Salary: _____ Prior Work Experience: _____ _____ _____ Educational Background: _____ _____ _____ _____ II. THE INCIDENT Date/Time of incident giving rise to this claim:_____ Location of incident giving rise to this claim:_____ Did the police respond to this incident?
CLIENT INFORMATION & INTERVIEW Personal Injury I. CLIENT INFORMATION Name: _____ Address: _____
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