Home Contact James O. Cunningham Personal Injury Case Evaluation Form

Personal Injury Case Evaluation Form

*Name:

*Address:

*City:

*State:

*Zip:

*E-mail address:

*Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

Who was injured?

If "Other," please describe:

Injured person's name (if different from above):

Address:

City:

State:

Zip:

E-mail address:

Home Phone:

Business Phone:

Cellular or Pager:

Facsimile:

When did the injury occur?

Where did the injury occur?

This location was the injured person's

If "Workplace," did the injury occur as a result of employment activities?
Yes   No 

If "Other," was this a road accident?
Yes   No 

If no, did the injury occur on another's property?
Yes   No 

If yes, who owns the property?

How did the injury happen?

What were the surrounding circumstances (weather, lighting, slipperiness, other)?

Were there witnesses to the injury?
Yes   No 

If yes, what are the witnesses names/contact information?

Were others involved or injured at the same time?
Yes   No 

If yes, what are their names/contact information?

Was there a police report?
Yes   No 

Did the injured person receive medical treatment?
Yes   No 

If yes, provide dates, locations, provider names, and details:

Is the injured person still receiving treatment?
Yes   No 

Was the injured person killed as a result of the accident?
Yes   No 

If yes, what was the date of his or her death?

Describe lifestyle changes experienced by the injured person and his or her family as a result of the accident:

Describe other losses resulting from the injury (lost wages, damaged property, other):

Where did you hear about this website?

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Martindale Hubbell | Highest Ethical standing
  • Mr. Cunningham is an excellent and knowledgeable attorney.

    I would and have recommended Mr. Cunningham as an attorney. I am extremely happy with the service he has provided for me and my family. I will definately use Mr. Cunningham in the future if I ever need an attorney again.

    - John, a Personal Injury client

Client Testimonials

5 StarsGreat Service (auto accident)
After totalling my vehicle my father recommended I retain Mr. Cunningham. A little online research lead us to Mr. Cunningham who made this case an easy process and educational. I recommend Jim Cunningham. He is doing a great service. Tyrone, an Auto Accident Client

5 StarsOutstanding Attorney
I was in an automobile accident and didn't know where to turn. My son-in-law recommended James Cunningham and I am so happy I took his advice. James and his staff were very professional and compassionate in guiding me through a difficult time. I highly recommend him. Hilda, an Auto Accident Client

5 StarsExcellent Service
Mr Cunninghan was a consientious, competant attorney and very professional. His service was excellent and we would recommend him highly. Barbara his assistance was also excellent in her services to us both. Lawrence, a Car Accident client

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