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Do I Have A Case Quiz - Rivas
If you are wondering if you have a case for your accident, we can help! Click START below.
12
Questions
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1
Did your accident occur because of any of the following?
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Commercial Vehicle Accident
Motorcycle Accident
Pedestrian / Bicycle Accident
Vehicle Accident
Defective Automobile Part
Other
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2
Did the police respond?
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Police reports are very persuasive in personal injury claims. Unlike the adjuster, the police officer was physically at the scene of the accident. The officer’s special training provides a reliable evaluation of the accident and its causes, especially each driver’s fault.
YES
NO
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3
Who received a citation
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Driver of the other vehicle was cited.
Driver of the vehicle I was riding in was cited.
No one was cited.
I was cited.
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4
When did your accident happen?
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It just happened.
This week.
This month.
More than a month ago.
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5
Were you injured in the accident?
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Yes
I'm not sure.
I have no injuries whatsoever.
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6
Which of the following best describes the injuries sustained?
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Select all that apply.
Death
Loss of Limbs
Head Injury / Concussion
Internal Injuries
Burns
Fractures
Scarring
Scrapes / Bruising
Pain / Stiffness / Soreness
Numbness / Tingling
Other
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7
What kind of medical care did you receive?
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Select all that apply.
Hospitalization
Emergency Room
Primary Care Doctor
Chiropractic
Pain Management
Neurology
Surgeon
None Yet
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8
Have you missed work because of the injury?
*
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Select all that apply.
I have been out of work since my injury.
I missed 1-2 days of work because of my injury.
I missed 1-2 weeks of work because of my injury.
I have not missed any work because of my injury.
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9
Has insurance offered you a settlement?
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YES
NO
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10
Did you accept the offer from the insurance?
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YES
NO
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11
Have you signed a release?
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YES
NO
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12
Contact Information
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We will contact you to discuss the options based on your quiz submission..
First Name
Last Name
Email
Phone Number
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