Questions for Depositions, Statements, and Trial

Create Injury Report examples like this template called Questions for Depositions, Statements, and Trial that you can easily edit and customize in minutes.

Text in this Example:

Fill name:
Current residence:
How long:
Residence on date of accident:
Age:
Marital status (then and now):
Children:
Employment on date of accident:
Where:
Duties:
Do you recall being involved in an accident on....:
Time of day:
am/pm
Day of week:
Who was driving:
Passengers:
Where were you seated:
What happened (narrative):
What did you see:
Did you know you were going to be hit:
Lanes of street:
Amount of traffic:
Divided highway
Parking on sides of street:
Which way do the streets run:
How fast were you traveling:
How fast was the other car traveling:
Which direction each traveling:
Questions for Depositions, Statements, and Trial
Turn signals:
Traffic controls:
Which part of the vehicles impacted each other:
What happened to your car upon impact:
Which way did vehicle spin:
Where did each stop:
What did you do after it stopped:
Where did your journey begin:
Where were you doing:
Purpose of trip:
When due to arrive:
Lightning:
Weather:
Slope of street:
Alcohol/Drugs:
All conversation at the scene:
Used horn or other warning device:
Skid marks:
When did police arrive:
Who called:
Conversation with police:
Radio:
Windshield wipers:
Windows:
Defroster:
Child in car:
Date of last eye examination:
Wearing glasses/contacts:
Car phone:
Stick shift/automatic transmission:
Smoking/eating (hands on wheel):
Where was the sun:
Wearing sunglasses:
Witnesses:
Who owned the car:
When was the car purchased:
Borrowed from owner:
Type of vehicle:
Where licensed to drive:
Since when:
Restrictions:
License ever suspended or revoked:
Describe other car:
Mechanical condition of your car:
Where and when was it last inspected:
What, if anything, happened to your body at the moment of impact:
What part of your body came into contact with the vehicle:
How did you feel at the moment of impact:
Seat belt:
Where you injured as a result of the accident:
What portion of your body came to your attention at the scene:
Investigation of accident:
What did you do about your injuries:
Emergency Room:
How did you get there:
Type of pain (sharp or dull, constant or intermittent):
What was done for you at ER:
Medication:
Orthopedic appliances:
When did you arrive at and leave the hospital:
arrived at
left at
How did you feel the next morning:
Did you go back to work that day:
Did you go anywhere else for treatment:
Why:
Purpose of visits:
Used ER equipment until first doctor's visit:
Family doctor:
Who referred:
Result of first doctor's visit:
What was complained of:
What was done on subsequent visits:
Describe treatment/therapy:
Exercises:
Whirlpool:
Where were exercises performed:
Did they bring relief:
For how long did you see this doctor:
How many times (total):
How many times per week:
What other doctor saw you:
Who referred you:
Specialists seen:
Medication - side effects:
When was the last medical treatment:
How did you feel then:
How have you felt since then:
How do you feel today:
How many days a week do you feel pain - what do you do for it:
Did pain lessen at any point in treatment:
When (for each injury):
Were you ever able to resume normal daily activities:
When:
Household duties:
Sports:
Driving:
Sleeping:
Social activities:
Marital difficulties:
How did you feel before accident:
Prior accidents:
How long were you treated:
Injuries:
How long before accident had you recovered:
Later accidents:
Next scheduled work after date of accident:
Did you go to work:
Work schedule:
Date that you returned to work:
Average weekly wage:
Why did you not stay home from work:
After you went back to work, was there any limitation because of the accident:
Inability to do job:
Where you carrying anything:
Describe your shoes:
Describe your clothing:
Which foot slipped:
Describe your fall:
What parts of your body hit the ground:
What caused you to fall:
Where were you looking
When had you last been to the scene of the accident:
Were you aware of the defect that caused your fall:
Did you have an alternate route: