Were you injured in an accident?

YES

NO

What caused the injury?

Car accident

Motorcycle accident

Truck or commercial vehicle accident

Pedestrian accident

Slip and fall

Construction or workplace injury

Something else

Where did the injury happen?

Brooklyn

Queens

Manhattan

The Bronx

Staten Island

Nassau County

Westchester county

Outside NYC

When did the injury happen?

Within the last 30 days

1 to 6 months ago

6 to 12 months ago

More than 1 year ago

Did you seek medical attention for this injury?

Yes, emergency room visit or ongoing treatment

Not yet, but planning to

No medical treatment

Who was at fault?

The other party was at fault

Unsure

I was partially at fault

I was at fault

Have you already contacted a lawyer?

No, not yet

Yes, but not satisfied

Yes, currently represented

What's your name?

How can we reach out?

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