New York Plaintiffs' Personal Injury Forms

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1 Brochure More information from New York Plaintiffs' Personal Injury Forms Description: The 750+ page book and CD of 325+ forms (in Word) serves as a comprehensive personal injury firm forms library. The CD of forms includes: Initial Intake Forms, Client Letters, Pre-Suit Forms, Sample Complaints, Discovery and Litigation Documents, Motions, Trial Documents, Settlement, and Appeal Documents. Low-tech and easy to use, the CD allows for easy drafting and editing of a large variety of Word documents. The 8 ½ x 11 soft cover book contains a printed version of each form, and is organized to bring you through your case start to finish. Contents: Intake Forms Motor Vehicle Premises Liability Product Liability Medical Malpractice Prior accident search Medical authorization-hipaa Retainer-sliding scale-short form Retainer-sliding scale-long form Retainer-one third-short form Retainer-one third-long form Stop Work Letter to Prior Attorney Retainer-one third-long form Stop Work Letter to Prior Attorney Client Forms Introduction letter to new client-referred by another attorney Introduction letter to new client-post phone interview Enclosing retainer Thank you-new client Request missing intake information Enclosing Med authorizations

2 Rejection letter-"serious injury" threshold Rejection letter-liability Rejection letter-business decision Request Property damage photos/estimate Requesting client's insurance information Arranging photographer appointment Enclosing No-Fault application-complete on separate sheets Advise of No-Fault IME Advise of No-Fault IME-Spanish Enclosing form-general Lien acknowledgement letter Treatment status letter with checklist Advise of 50-h Hearing Enclosing 50-h transcript Arranging product inspection Arranging location inspection Enclosing copy of No-Fault exam Advise of scar evaluation Enclosing consent to change attorney Enclose draft S & C with Indiv. Verification Enclosing filed summons and complaint BP update letter with form Enclosing authorization from defense Encl. auths from defense-spanish Requesting D & I items Enclosing Interrogatories-Product Liability case Enclose draft BP with Indiv. Verification Supplemental BP update letter Enclosing copy of Defense Medical exam Advise of co-counsel/trial counsel Enclose copy of PC Order, request items

3 Advise Client of Deposition(EBT)-same day preparation Advise client of Deposition(EBT)-advance date preparation Advise of Mediation-Must appear Advise of Mediation-On call Advise of Settlement Conference-Appearance needed Advise of Settlement Conference-On Call Advise client of Defense medical exam Client enclosing EBT transcript with correction affidavit Advise client of plaintiff's independent medical exam Contact office-settlement authority Contact office-discuss settlement offer Return to doctor for narrative report Return to doctor before trial Advise of trial date Advise of trial date-spanish Advise client of pre-infant's Compromise Exam Enclosing Release Enclosing Release-Spanish Enclosing proposed Closing Statement Enclosing settlement check Enclosing settlement check-spanish Enclosing Infants Compromise documents Advise of Infants Compromise Hearing Pre-Suit Forms School Employment Health Insurance Legal file-prior matter Vehicle Maintenance records Medical-HIPAA

4 Medical-HIPAA-NYC Health & Hospitals Worker's compensation file No-Fault file Tax Records Authorization (IRS Form 4503) Insurance records (Collision/Property Damage claim file) UM/UIM/SUM carrier letter of rep/reservation MVAIC form MVAIC cover letter UM/UIM/SUM Arbitration Demand UM/UIM/SUM Arbitration cover letter to carrier UM/UIM/SUM Arbitration-letter to AAA enclosing fee To defendant auto owner/driver To property owner To No-Fault insurance carrier To tortfeasor's insurance carrier To trucking company To referring/participating attorney Spoliation letter-party retaining evidence Nursing Home with records request Stop Work from client to prior attorney To prior attorney To referring client Providing No-Fault info to medical provider To No-Fault carrier enclosing No-Fault application To No-Fault carrier enclosing bills Postal Search Photographer to take pictures Police report request Witness letter-mva Witness letter-premises case Request Traffic Court disposition To hospital-initial letter

5 Hospital-enclosing $$ Title Company property owner search Weather report company search Settlement packet to adverse insurer To doctor-initial letter To doctor-enclosing $$ To doctor requesting billing records To doctor as defendant in malpractice action Requesting diagnostic studies To health insurer To employer To school To No-Fault insurer-regular To No-Fault insurer-request electronic copy No Fault carrier or copy service enclosing $$ WC Carrier WC carrier-enclosing $$ Port Authority of NY & NJ-N.O.C General Municipal Law entity-n.o.c.-mva General Municipal Law entity-n.o.c.-playground General Municipal Law entity-n.o.c.-subway General Municipal Law entity-n.o.c.-sidewalk Pari-Mutual Law entity-n.o.c Court of Claims-Notice of Intention Notice of Claim cover letter to entity Notice of Claim letter to process server No-Fault Arbitration Demand Assignment of Benefits form Complaints

6 Index Number application-general NY County Addendum Index Number application-rockland Index Number application-westchester Index Number Application-Broome County Verification-Individual Verification-Attorney (substitute for individual) Verification-Corporate Summons Legal Backing Pedestrian struck by car Motorcyclist struck by car Bicyclist struck by car Roadway defect accident Passenger in single vehicle accident Passenger in two car accident-sue both vehicles Passenger in two car accident-sue other vehicle only Two passengers Driver in two car accident Passenger and driver in rear end accident Driver in multi-car accident Truck accident complaint Sidewalk accident Falldown on property Ceiling fall down Falling merchandise Subway/train step or platform Construction/Labor Law Nursing Home Medical Malpractice-General Medical Malpractice-Informed consent Medical Malpractice-Foreign Object

7 Medical Malpractice-Continuous Treatment Dental Malpractice Podiatric Malpractice Dropped patient-negligence only Certificate of Merit-Malpractice case Playground Food-foreign object Industrial/household product Assault Dog Bite Wrongful Death Food poisoning Slander/Libel Emotional Distress Loss of Services Discovery and Litigation Product Liability Interrogatories Supplemental Truck Accident D & I Combined Discovery & Inspection Demands Deposition Notice (d) Product Liability Demands Medical Malpractice Demands Premises Liability demands EBT Notice Cross-EBT Notice Notice to Admit Affidavit of Mailing Demand for Defense Medical Exam

8 EBT Correction/Errata Affidavit Response to Preliminary Conference Order MVA-standard responses Premises Liability-standard responses Medical Malpractice-standard responses Trucking case-standard responses Injuries-standard responses (d)-Medical (d)-Economic (d)-liability (d)-Reconstruction RJI Request for Preliminary Conference Consent to Change Attorney Substitution of Attorney Affidavit of Service-process server to complete-individual Affidavit of Service-process server to complete-corporate Attorney Change of Address OCA Criminal History Search Form Court enclosing S & C Court enclosing Affidavit(s) of Service Court enclosing Motion Court enclosing Opposition to Motion Court enclosing Order to Show Cause To defendant enclosing filed S & C To defense insurer enclosing filed S & C Lien acknowledgement letter to doctor Letter of Protection To process server -serve defendants Process server-vtl service Process server-secretary of State service To per diem attorney confirming appearance

9 To court reporter-advise of dep/ebt To videographer-advise of dep/ebt Encl packet to plaintiff's independent medical exam doctor Motions Pre-suit Petition Substituted Service pursuant to CPLR 308 (5) Default Judgment Compel discovery Extend Note of Issue filing time Summary Judgment-Liability Restore to Calendar Trial Preference Bifurcate Damages from Liability Notice of Motion in Limine Affirmation in Support of Motion In Limine "Serious injury" Threshold opposition Liability motion opposition Consolidation Joint Trial Granting Summary Judgment Order to Show Cause-General Order to Show Cause-Relieved as Counsel Affirmation in Support of Request to Be Relieved Order Setting Inquest (Assessment of Damages) Injunctive Relief Order/Judgment Confirming Arbitration Award Notice of Settlement Notice of Entry

10 Stipulation Adjourning Motion Trial Note of Issue Certificate of Readiness Stipulation as to Discovery Completion Affirmation as to Discovery Completion Letter to Medical Illustrator for Exhibits Letter to expert regarding trial date Letter to doctor regarding trial date Notice of Trial Counsel Subpoena "So Ordered" Subpoena Judicial Subpoena Settlement Release-MVA Release-Other Tort Stipulation of Settlement Stipulation of Discontinuance Infant's Compromise Order-Basic Infant's Compromise Order-Simple Structured Settlement Infant's Compromise Order-Complex Structured Settlement Structure Broker Affidavit Infant's Compromise Calculation Sheet Death Compromise/Wrongful Death Order To referring/participating attorney To defense attorney confirming settlement To defense attorney enclosing settlement docs To defense carrier enclosing settlement docs

11 To medical expert-advise case settled-thank you To other expert-advise case settled To medical doctor enclosing meds for infants compromise affirmation Court advising case settled To WC carrier paying lien To med provider paying lien To ERISA carrier paying lien To Creditor paying lien or judgment CMS authorization Request for conditional amount/demand letter Closing statement Letter enclosing closing statement Appeals Notice of Appeal Notice of Motion Order to Show Cause Attorney's Affirmation Record on Appeal Cover page Appellant's Brief Cover Page CPLR 5531 Statement Pre-Argument Statement-1st Department Request For Appellate Division Intervention (RADI)-2nd Dept Pre-Calendar Statement-3rd Department Affidavit of Service Motion for Leave to Appeal Affirmation in Support of Motion for Leave Worker's Compensation Employee's Claim for Worker's Compensation (C-3)

12 Spanish Information Sheet for C Attending Doctor's Report (C-4) C-4 Continuation Form-additional billing codes/treatment dates Attending Ophthalmologists Report (c-5) Affidavit for Death Benefits-Spouse or Child (AFF-1) Affidavit for Death Benefits-Sibling (AFF-2) Affidavit for Death Benefits-Parent or Grandparent (AFF-3) Application for Advance on Periodic Payments (C-21) Re-opener Application (C-25) Settlement Agreement (C-32) Release (C-32.1) Death Case Claim (C-64) Proof of Burial and Funeral Expenses (C-65) Records of Hearing Loss Proof (C-72.1) Notice of Third Party Action Claimant's Records of Medical/Travel Expenses (C-257) Disability Benefits Claim Form (DB-300) Attending Doctor's Request for Authorization (MD-1) Claimant's Authorization to Release WC Records (OC-110A) Notice of Retainer/Substitution (OC-400) Attorney Fee Application (OC-400.1) Statement on Disputed Issues (PH-16.2) Ordering: Order Online - Order by Fax - using the form below Order by Post - print the order form below and send to Research and Markets, Guinness Centre, Taylors Lane, Dublin 8, Ireland.

13 Page 1 of 2 Fax Order Form To place an order via fax simply print this form, fill in the information below and fax the completed form to (from USA) or (from Rest of World). If you have any questions please visit Order Information Please verify that the product information is correct. Product Name: Web Address: Office Code: New York Plaintiffs' Personal Injury Forms SC Product Format Please select the product format and quantity you require: Hard Copy and CD-ROM - Single User: Quantity USD USD 28 Shipping/Handling * Shipping/Handling is only charged once per order. Contact Information Please enter all the information below in BLOCK CAPITALS Title: Mr Mrs Dr Miss Ms Prof First Name: Last Name: Address: * Job Title: Organisation: Address: City: Postal / Zip Code: Country: Phone Number: Fax Number: * Please refrain from using free accounts when ordering (e.g. Yahoo, Hotmail, AOL)

14 Page 2 of 2 Payment Information Please indicate the payment method you would like to use by selecting the appropriate box. Pay by credit card: You will receive an with a link to a secure webpage to enter your credit card details. Pay by check: Please post the check, accompanied by this form, to: Research and Markets, Guinness Center, Taylors Lane, Dublin 8, Ireland. Pay by wire transfer: Please transfer funds to: Account number Sort code Swift code IBAN number Bank Address ULSBIE2D IE78ULSB Ulster Bank, Main Street, Blackrock, Co. Dublin, Ireland. If you have a Marketing Code please enter it below: Marketing Code: Please note that by ordering from Research and Markets you are agreeing to our Terms and Conditions at Please fax this form to: (646) or (646) From USA or From Rest of World

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