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Florida Accident and Wrongful Death

Potential Client Intake Form

The Law Offices of Carolina Nunez, P.A.

About You

What happened?

Accident Case Details

Was an insurance policy involved?

Date of Accident

Have you already spoken to or hired another lawyer about this matter?
Where did this accident occur?

Tell Us Your Story

Do NOT include sensitive information such as social security numbers or policy numbers.

You're Almost Done!

Why We Request These Documents (Florida Accident Cases)

  • Photo ID: To verify your identity and ensure accurate filings.

  • Accident Photos: To document damage, injuries, and fault.

  • Health Insurance Card: To coordinate medical billing and coverage.

  • Car Insurance Card: To confirm PIP and other available coverage under Florida law.

  • Police Report: To review liability findings and obtain official crash details.

These documents help us evaluate and protect your claim quickly.

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By signing above, I acknowledge and agree to the above terms. I understand that my electronic signature has the same legal validity and enforceability as a handwritten signature.

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