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Were You A Driver, Passenger or Pedestrian
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Passenger
Pedestrian
Bicyclist
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What is the extent of your vehicle or personal damage?
Totalled
Severe Damage
Fender Bender
Not Applicable
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When was the accident?
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March
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What is the other driver's vehicle type?
Car
Commercial Vehicle
Motorcycle
Not Sure
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What Type of Vehicle Were You Driving?
Car
Commercial Vehicle
Motorcycle
I Was A Passenger or Pedestrian
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Is there another identifiable party at fault for the accident?
Driver of the vehicle was found at fault
No, I was found at fault
The accident was caused by road conditions
The accident was caused by an animal
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Were You Injured?
Yes
No
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What type of medical treatment did you receive?
Treated by Ambulance Crew and Released
Taken to Emergency Room
Doctor's Office
No Treatment
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Are you or have you been represented by a lawyer in this matter?
Yes, I have a lawyer
NO, I NEED A LAWYER
Yes, but I want a new lawyer
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Please describe your accident
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