Client Legal Resources2018-01-26T00:51:26+00:00

Client Progress Form

Please fill out the following form to update us on your current physical condition and medical treatment. All information you provide is sent directly to your attorney and is protected by the attorney-client privilege.

If you would prefer to fill out a hard copy of this form, or would like additional copies of this form, please call our office.

If you have medical bills that you have not submitted to us yet you can send them via Email or Fax to the addresses below, or give us a call and we’ll be happy to assist you!

[1] During the past 3 months, have you suffered any pains from your injuries?
YesNo

[2] During the past 3 months, did you have any visible signs of injury, such as a bruise, discoloration, cut, scar, swelling, or lump?
YesNo

[4] During the past 3 months, did you receive any examination, tests or care in any hospital?
YesNo

[5] During the past 3 months, did you take any medicine for your pain or injuries?
YesNo

[6] If you used any of the following medical aids in the past 3 months, please indicate which ones by checking the boxes that apply:
braceappliancebandagetractioncrutcheswheelchairspecial bedmattress or boardmedical collarother aidsnone

[7] During the past 3 months, did you take any home treatments (such as heat lamp, electric pad, hot water bottle, hot bath or shower, massage, special exercise, etc.)?
YesNo

[8a] During the past 3 months, was there anything at work, home or elsewhere THAT YOU COULD NOT DO because of your injuries?
YesNo

[8b] During the past 3 months, was there anything at work, home or elsewhere THAT YOU FOUND MORE DIFFICULT TO DO because of your injuries?
YesNo

[9] During the past 3 months, did you receive any new injuries not related to this accident?
YesNo

[10] During the past 3 months, did you receive any hospital, doctor or other medical consultation or treatment for any cause other than your injuries in this case?
YesNo

[11] During the past 3 months, did you lose any time from work because of your injuries?
YesNo

[recaptcha]

Progress Form

Please fill out the following form to update us on your current physical condition and medical treatment. All information you provide is sent directly to your attorney and is protected by the attorney-client privilege.

If you would prefer to fill out a hard copy of this form, or would like additional copies of this form, please call our office.

If you have medical bills that you have not submitted to us yet you can send them via Email or Fax to the addresses below, or give us a call and we’ll be happy to assist you!

[1] During the past 3 months, have you suffered any pains from your injuries?
YesNo

[2] During the past 3 months, did you have any visible signs of injury, such as a bruise, discoloration, cut, scar, swelling, or lump?
YesNo

[4] During the past 3 months, did you receive any examination, tests or care in any hospital?
YesNo

[5] During the past 3 months, did you take any medicine for your pain or injuries?
YesNo

[6] If you used any of the following medical aids in the past 3 months, please indicate which ones by checking the boxes that apply:
braceappliancebandagetractioncrutcheswheelchairspecial bedmattress or boardmedical collarother aidsnone

[7] During the past 3 months, did you take any home treatments (such as heat lamp, electric pad, hot water bottle, hot bath or shower, massage, special exercise, etc.)?
YesNo

[8a] During the past 3 months, was there anything at work, home or elsewhere THAT YOU COULD NOT DO because of your injuries?
YesNo

[8b] During the past 3 months, was there anything at work, home or elsewhere THAT YOU FOUND MORE DIFFICULT TO DO because of your injuries?
YesNo

[9] During the past 3 months, did you receive any new injuries not related to this accident?
YesNo

[10] During the past 3 months, did you receive any hospital, doctor or other medical consultation or treatment for any cause other than your injuries in this case?
YesNo

[11] During the past 3 months, did you lose any time from work because of your injuries?
YesNo

[recaptcha]

Legal Resources

TOPIC: ATTORNEY FLAHAVAN NAMED HIGHEST RATED ATTORNEY

Date: April 07, 2016
Link: Attorney Flahavan Receives Highest Rating Press Release

TOPIC: MEDICAL LIENS

Date: February, 2016
Description: Good article on Medical Liens.
LinkMedical Liens and the Current Status of Howell

Legal Resources

TOPIC: ATTORNEY FLAHAVAN NAMED HIGHEST RATED ATTORNEY

Date: April 07, 2016
Link: Attorney Flahavan Receives Highest Rating Press Release

TOPIC: MEDICAL LIENS

Date: February, 2016
Description: Good article on Medical Liens.
LinkMedical Liens and the Current Status of Howell

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