Wrongful Death Case Evaluation

Please answer as many of the following questions as you can.

Name:
Address:
City:
State:
Zip Code:
Email Address:
Phone Number:
Name on the deceased:
What is your relation to the deceased?
Who caused this wrongful death?
What exactly occurred to cause this loss?
How could this loss have been avoided by the at-fault party?
Was the deceased married? Separated or Divorced? To whom?
Did the deceased have children? How many? Name(s) & Age(s) of all?
How many people were in the lost love one’s immediate family?
Who else did the deceased individual support? Name(s)& Age(s) of all?
How has this loss emotionally and financially affected the deceased’s family’s life?
Any other special concerns?

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