This form is by the plaintiff's attorney to request from client's medical provider information regarding the client's injuries and treatment.
Virginia Letter regarding Client's Injuries and Diagnosis
State:
Multi-State
Control #:
US-PI-0259
Format:
Word;
Rich Text
Instant download
Description
How to fill out Letter Regarding Client's Injuries And Diagnosis?
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FAQ
In particular, it should provide the following information: Details about how the accident occurred. The date and time of the accident or incident. Where the accident occurred. ... Briefly, the reason why the Claimant alleges the accident was the Defendant's fault. Brief details of the Claimant's injuries.
Dear [Supervisor Name]: I am respectfully presenting this letter as written notice that I was involved in a work-related accident on [date of incident] at approximately [time of incident]. [I was injured / I became ill] when [give clear details involving the accident, including what led up to it].
Describe all your injuries, both physical and emotional, and all the treatments you've received. And don't be shy. Emphasize your pain, the length and difficulty of your recovery, and any negative effects your injuries have had on your daily life (such as "pain and suffering," and your "emotional distress").
Injury and Lost Time Incident Report Sample Type of incident (injury, near miss, property damage, or theft) Location (Address) Date/time of incident. Name. Name of supervisor. Description of the incident, including specific job site location, the sequence of events, and the results of the event.
Thoroughly explain your pain In your letter, feel free to describe each step in your path of recovery. Carefully and thoughtfully relate all pain and suffering you experienced as a result of the injury. When adding up your damages, make sure you list all hard costs and general damages.
