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Motor Vehicle Accidents Contact Form

Name

Email Address

Phone Number

When and where did the accident occur?

What were the conditions? Light/Dark? Wet/Dry? Snow/Ice?

Where were you sitting in the vehicle? Were you driving?

Who owns the vehicle? Is it insured?

Describe how the accident happened.

Did the police come to the scene of the accident?
Yes  No 

Were any citations issued or arrests made? In your opinion was alcohol a factor in causing the accident?

Was either driver found to be at fault for a hazardous action? Do you have a copy of the police report?

Were you injured in the accident?
Yes  No 

Were you taken to the hospital? How were you taken to the hospital?

What medical treatment have you received? Are you currently receiving medical treatment?

Were you insured on the day of the accident? Was the driver of the other vehicle(s) insured?

Are you currently under a physicians care for the injuries sustained in the accident?

 
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ORLANDO OFFICE
1500 E. Robinson Street
Orlando, FL 32801
Telephone: (407) 228-3838

WINTER PARK OFFICE
1211 Orange Avenue
Winter Park, FL 32789
Telephone: (407) 599-3838

Contact Us Today 407-228-3838 or use the form below
Did you know?

In 2001, the number of people who died in transportation accidents (cars, trucks, buses, etc.) was 47,288. According to the National Safety Council, a person born in 2001 has a one in 78 chance of being killed in a traffic or auto accident during their lifetime.