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Blain LLC

Pre-Intake

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4. Something happened. 

Who did it happen to?
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5. What kind of harm was caused?​ *This question is required.
6. We're sorry to ask this, but was there a death because of what happened?
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9. Let's talk about what happened.

Did it happen while you were working?
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10. Did it involve:

a car, truck, or other motorized vehicle?
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11. Did it involve:

violence (attack, assault, rape, shooting...)?
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12. Did it involve:

a product (something purchased or used) not doing what it was supposed to? 
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13. Did it involve:

alcohol?
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14. Did it involve:

a fall (trip, slip, fall, plummet, tumble...)?
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15. Did what happened involve:

a doctor, dentist, or other medical professional while they were working?
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16. Was the driver working for an employer when it happened? *This question is required.
16. Where did it happen? *This question is required.
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17. Have you already filed a lawsuit based on what happened? *This question is required.
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23. What is your preferred communication method to discuss what happened?