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Truck Accidents Information Center

Truck Accidents Contact Form

*First Name

*Last Name

*Email Address

*Phone Number


Street Address


Incident Street Address

Incident Apt/Ste

*Incident Zip

Were you or a loved one the victim of an accident involving a commercial truck?

If the victim was a loved one, what is your relationship with that person?

When and where did the accident occur?

Were you or your loved one a passenger, driver, or pedestrian?

How did the accident occur? Describe what happened.

What kind of truck was involved?

Do you know the name of the driver?

His or her trucking company?

His or her employer?

Was a police report generated by the accident?

Do you know if any traffic citations were issued?

Do you know the names of any witnesses to the accident?

What injuries were sustained as a result of the accident?

Did you seek and are you currently receiving medical treatment as a result of the accident?

What is your prognosis?

Have you discussed this matter with your own insurance representative?

Have you discussed this matter with any insurance representative or attorney representing other parties involved in the accident?

How has this accident affected your overall quality of life and well-being?

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