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Library of New York Plaintiffs' Personal Injury Forms

Standing Order with Automatic Update Service

Lawrence M. Simon

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$310.00
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        The 750+ page book and CD of 325+ forms (in Word) serves as a comprehensive personal injury firm forms library. The CD of forms includes: Initial Intake Forms, Client Letters, Pre-Suit Forms, Sample Complaints, Discovery and Litigation Documents, Motions, Trial Documents, Settlement, and Appeal Documents. Low-tech and easy to use, the CD allows for easy drafting and editing of a large variety of Word documents. The 8 ½ x 11 soft cover book contains a printed version of each form, and is organized to bring you through your case start to finish.

 

Use Library of New York Plaintiffs' Personal Injury Forms to walk through the following personal injury matters:

Motor Vehicle

Medical Malpractice

Premises Liability

Product Liability

Wrongful Death

Worker's Compensation



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  • Availability: Available
  • Brand: New York Law Journal Books
  • Product Type: Books
  • Edition: 0
  • ISBN: 978-1-57625-313-7
  • Pub#/SKU#: NPINF15

Author Image
  • Lawrence M. Simon

Lawrence Simon (The Law Offices of Lawrence M. Simon) has offices located in Midtown Manhattan, Orange County, and Northern New Jersey. Simon practices in Personal Injury litigation, Product Liability law, and matters involving Wrongful Death. He is a member of the Association of Trial Lawyers of America, the New York State Trial Lawyers Associations,  and the American Bar Association. He has been named an Advocate of Trial Advocacy by ATLA, and serves as an ATLA Ambassador to New York Law School


 

Table of Contents

 

 

 

 

 

 

 

Intake Forms

 

Interview form

01-001

Motor Vehicle

 

01-002

Premises Liability

 

01-003

Product Liability

 

01-004

Medical Malpractice

Intake documents

01-005

Prior accident search

 

01-006

Medical authorization-HIPAA

 

01-007

Retainer-sliding scale-short form

 

01-008

Retainer-sliding scale-long form

 

01-009

Retainer-one third-short form

 

01-010

Retainer-one third-long form

 

01-011

Stop Work Letter to Prior Attorney

 

01-010

Retainer-one third-long form

 

01-011

Stop Work Letter to Prior Attorney

 

 

 

 

 

 

 

Client Forms

 

Letter

02-001

Introduction letter to new client-referred by another attorney

 

02-002

Introduction letter to new client-post phone interview

 

02-003

Enclosing retainer

 

02-004

Thank you-new client

 

02-005

Request missing intake information

 

02-006

Enclosing Med authorizations

 

02-007

Rejection letter-"Serious injury" threshold

 

02-008

Rejection letter-Liability

 

02-009

Rejection letter-business decision

 

02-010

Request Property damage photos/estimate

 

02-011

Requesting client's insurance information

 

02-012

Arranging  photographer appointment

 

02-013

Enclosing No-Fault application-complete on separate sheets

 

02-014

Advise of No-Fault IME

 

02-015

Advise of No-Fault IME-Spanish

 

02-016

Enclosing form-general

 

02-017

Lien acknowledgement letter

 

02-018

Treatment status letter with checklist

 

02-019

Advise of 50-h Hearing

 

02-020

Enclosing 50-h transcript

 

02-021

Arranging product inspection

 

02-022

Arranging location inspection

 

02-023

Enclosing copy of No-Fault exam

 

02-024

Advise of scar evaluation

 

02-025

Enclosing consent to change attorney

 

02-026

Enclose draft S & C with Indiv. Verification

 

02-027

Enclosing filed summons and complaint

 

02-028

BP update letter with form

 

02-029

Enclosing authorization from defense

 

02-030

Encl. auths from defense-Spanish

 

02-031

Requesting D & I items

 

02-032

Enclosing Interrogatories-Product Liability case

 

02-033

Enclose draft BP with Indiv. Verification

 

02-034

Supplemental BP update letter

 

02-035

Enclosing copy of Defense Medical exam

 

02-036

Advise of co-counsel/trial counsel

 

02-037

Enclose copy of PC Order, request items

 

02-038

Advise Client of Deposition(EBT)-same day preparation

 

02-039

Advise client of Deposition(EBT)-advance date preparation

 

02-040

Advise of Mediation-Must appear

 

02-040

Advise of Mediation-On call

 

02-041

Advise of Settlement Conference-Appearance needed

 

02-042

Advise of Settlement Conference-On Call

 

02-043

Advise client of Defense medical exam

 

02-044

Client enclosing EBT transcript with correction affidavit

 

02-045

Advise client of plaintiff's independent medical exam

 

02-046

Contact office-settlement authority

 

02-047

Contact office-discuss settlement offer

 

02-048

Return to doctor for narrative report

 

02-049

Return to doctor before trial

 

02-050

Advise of trial date

 

02-051

Advise of trial date-Spanish

 

02-052

Advise client of pre-Infant's Compromise Exam

 

02-053

Enclosing Release

 

02-054

Enclosing Release-Spanish

 

02-055

Enclosing proposed Closing Statement

 

02-056

Enclosing settlement check

 

02-057

Enclosing settlement check-Spanish

 

02-058

Enclosing Infants Compromise documents

 

02-059

Advise of Infants Compromise Hearing

 

 

 

 

 

 

 

Pre-Suit Forms

 

Authorizations

03-001

School

 

03-002

Employment

 

03-003

Health Insurance

 

03-004

Legal file-prior matter

 

03-005

Vehicle Maintenance records

 

03-006

Medical-HIPAA

 

03-007

Medical-HIPAA-NYC Health & Hospitals

 

03-008

Worker's compensation file

 

03-009

No-Fault file

 

03-010

Tax Records Authorization (IRS Form 4503)

 

03-011

Insurance records (Collision/Property Damage claim file)

Uninsured/Hit & Run

03-012

UM/UIM/SUM carrier letter of rep/reservation

 

03-013

MVAIC form

 

03-014

MVAIC cover letter

 

03-015

UM/UIM/SUM Arbitration Demand

 

03-016

UM/UIM/SUM Arbitration cover letter to carrier

 

03-017

UM/UIM/SUM Arbitration-letter to AAA enclosing fee

Letter of Representation

03-018

To defendant auto owner/driver

 

03-019

To property owner

 

03-020

To No-Fault insurance carrier

 

03-021

To tortfeasor's insurance carrier

 

03-022

To trucking company

 

03-023

To referring/participating attorney

 

03-024

Spoliation letter-party retaining evidence

 

03-025

Nursing Home with records request

Other letters

03-026

Stop Work from client to prior attorney

 

03-027

To prior attorney

 

03-028

To referring client

 

03-029

Providing No-Fault info to medical provider

 

03-030

To No-Fault carrier enclosing No-Fault application

 

03-031

To No-Fault carrier enclosing bills

 

03-032

Postal Search

 

03-033

Photographer to take pictures

 

03-034

Police report request

 

03-035

Witness letter-MVA

 

03-036

Witness letter-Premises case

 

03-037

Request Traffic Court disposition

 

03-038

To hospital-initial letter

 

03-039

Hospital-enclosing $$

 

03-049

Title Company property owner search

 

03-050

Weather report company search

 

03-051

Settlement packet to adverse insurer

Records request

03-052

To doctor-initial letter

 

03-053

To doctor-enclosing $$

 

03-054

To doctor requesting billing records

 

03-055

To doctor as defendant in malpractice action

 

03-056

Requesting diagnostic studies

 

03-057

To health insurer

 

03-058

To employer

 

03-059

To school

 

03-060

To No-Fault insurer-regular

 

03-061

To No-Fault insurer-request electronic copy

 

03-062

No Fault carrier or copy service enclosing $$

 

03-063

WC Carrier

 

03-064

WC carrier-enclosing $$

Notice of Claim related

03-065

Port Authority of NY & NJ-N.O.C.

 

03-066

General Municipal Law entity-N.O.C.-MVA

 

03-067

General Municipal Law entity-N.O.C.-Playground

 

03-068

General Municipal Law entity-N.O.C.-Subway

 

03-069

General Municipal Law entity-N.O.C.-Sidewalk

 

03-070

Pari-Mutual Law entity-N.O.C.

 

03-071

Court of Claims-Notice of Intention

 

03-072

Notice of Claim cover letter to entity

 

03-073

Notice of Claim letter to process server

Additional No-Fault

03-074

No-Fault Arbitration Demand

 

03-075

Assignment of Benefits form

 

 

 

 

Complaints

 

Required forms

04-001

Index Number application-General

 

04-002

NY County Addendum

 

04-003

Index Number application-Rockland

 

04-004

Index Number application-Westchester

 

04-005

Index Number Application-Broome County

 

04-006

Verification-Individual

 

04-007

Verification-Attorney (substitute for individual)

 

04-008

Verification-Corporate

 

04-009

Summons

 

04-010

Legal Backing

MVA Complaint

04-011

Pedestrian struck by car

 

04-012

Motorcyclist struck by car

 

04-013

Bicyclist struck by car

 

04-014

Roadway defect accident

 

04-015

Passenger in single vehicle accident

 

04-016

Passenger  in two car accident-sue both vehicles

 

04-017

Passenger in two car accident-sue other vehicle only

 

04-018

Two passengers

 

04-019

Driver in two car accident

 

04-020

Passenger and driver in rear end accident

 

04-021

Driver in multi-car accident

 

04-022

Truck accident complaint

Premises Liability

04-023

Sidewalk accident

 

04-024

Falldown on property

 

04-025

Ceiling fall down

 

04-026

Falling merchandise

 

04-027

Subway/train step or platform

Malpractice/Neglect

04-028

Construction/Labor Law

 

04-029

Nursing Home

 

04-030

Medical Malpractice-General

 

04-031

Medical Malpractice-Informed consent

 

04-032

Medical Malpractice-Foreign Object

 

04-033

Medical Malpractice-Continuous Treatment

 

04-034

Dental Malpractice

 

04-035

Podiatric Malpractice

Related

04-036

Dropped patient-negligence only

Product Liability

04-037

Certificate of Merit-Malpractice case

 

04-038

Playground

 

04-039

Food-foreign object

Other

04-040

Industrial/household product

 

04-041

Assault

 

04-042

Dog Bite

 

04-043

Wrongful Death

 

04-044

Food poisoning

 

04-045

Slander/Libel

 

04-046

Emotional Distress

 

04-047

Loss of Services

 

 

 

 

Discovery and Litigation

Demand/Notice

05-001

Product Liability Interrogatories

 

05-002

Supplemental Truck Accident D & I

 

05-003

Combined Discovery & Inspection Demands

 

05-004

Deposition Notice

 

05-005

3101(d)

 

05-006

Product Liability Demands

 

05-007

Medical Malpractice Demands

 

05-008

Premises Liability demands

 

05-009

EBT Notice

 

05-010

Cross-EBT Notice

 

05-011

Notice to Admit

Related forms

05-012

Affidavit of Mailing

 

05-013

Demand for Defense Medical Exam

 

05-014

EBT Correction/Errata Affidavit

Discovery Responses/BPs

05-015

Response to Preliminary Conference Order

 

05-016

MVA-standard responses

 

05-017

Premises Liability-standard responses

 

05-018

Medical Malpractice-standard responses

 

05-019

Trucking case-standard responses

 

05-020

Injuries-standard responses

 

05-021

3101(d)-Medical

 

05-022

3101(d)-Economic

 

05-023

3101 (d)-Liability

 

05-024

3101(d)-Reconstruction

Court Filings/Documents

05-025

RJI

 

05-026

Request for Preliminary Conference

 

05-027

Consent to Change Attorney

 

05-028

Substitution of Attorney

 

05-029

Affidavit of Service-process server to complete-individual

 

05-030

Affidavit of Service-process server to complete-corporate

 

05-031

Attorney Change of Address

 

05-032

OCA Criminal History Search Form

Letter

05-033

Court enclosing S & C

 

05-034

Court enclosing Affidavit(s) of Service

 

05-035

Court enclosing Motion

 

05-036

Court enclosing Opposition to Motion

 

05-037

Court enclosing Order to Show Cause

 

05-038

To defendant enclosing filed S & C

 

05-039

To defense insurer enclosing filed S & C

 

05-040

Lien acknowledgement letter to doctor

 

05-041

Letter of Protection

 

05-042

To process server -serve defendants

 

05-043

Process server-VTL service

 

05-044

Process server-Secretary of State service

 

05-045

To per diem attorney confirming appearance

 

05-046

To court reporter-advise of dep/EBT

 

05-047

To videographer-advise of dep/EBT

 

05-048

Encl packet to plaintiff's independent medical exam doctor

 

 

 

 

Motions

 

Motion

06-001

Pre-suit Petition

 

06-002

Substituted Service pursuant to CPLR 308 (5)

 

06-003

Default Judgment

 

06-004

Compel discovery

 

06-005

Extend Note of Issue filing time

 

06-006

Summary Judgment-Liability

 

06-007

Restore to Calendar

 

06-008

Trial Preference

 

06-009

Bifurcate Damages from Liability

 

06-010

Notice of Motion in Limine

 

06-011

Affirmation in Support of Motion In Limine

Opposition

06-012

"Serious injury" Threshold opposition

 

06-013

Liability motion opposition

Orders

06-014

Consolidation

 

06-015

Joint Trial

 

06-016

Granting Summary Judgment

 

06-017

Order to Show Cause-General

 

06-018

Order to Show Cause-Relieved as Counsel

 

06-019

Affirmation in Support of Request to Be Relieved

 

06-020

Order Setting Inquest (Assessment of Damages)

 

06-021

Injunctive Relief

 

06-022

Order/Judgment Confirming Arbitration Award

Related Forms

06-023

Notice of Settlement

 

06-024

Notice of Entry

 

06-025

Stipulation Adjourning Motion

 

 

 

 

Trial

 

 

07-001

Note of Issue

 

07-002

Certificate of Readiness

 

07-003

Stipulation as to Discovery Completion

 

07-004

Affirmation as to Discovery Completion

 

07-005

Letter to Medical Illustrator for Exhibits

 

07-006

Letter to expert regarding trial date

 

07-007

Letter to doctor regarding trial date

 

07-008

Notice of Trial Counsel

 

07-009

Subpoena

 

07-010

"So Ordered" Subpoena

 

07-011

Judicial Subpoena

 

 

 

 

Settlement

 

Release

08-001

Release-MVA

 

08-002

Release-Other Tort

Stipulation

08-003

Stipulation of Settlement

 

08-004

Stipulation of Discontinuance

Child/Death

08-005

Infant's Compromise Order-Basic

 

08-006

Infant's Compromise Order-Simple Structured Settlement

 

08-007

Infant's Compromise Order-Complex Structured Settlement

 

08-009

Structure Broker Affidavit

 

08-010

Infant's Compromise Calculation Sheet

 

08-011

Death Compromise/Wrongful Death Order

Letter

08-012

To referring/participating attorney

 

08-013

To defense attorney confirming settlement

 

08-014

To defense attorney enclosing settlement docs

 

08-015

To defense carrier enclosing settlement docs

 

08-016

To medical expert-advise case settled-thank you

 

08-017

To other expert-advise case settled

 

08-018

To medical doctor enclosing meds for infants compromise affirmation

 

08-019

Court advising case settled

 

08-020

To WC carrier paying lien

 

08-021

To med provider paying lien

 

08-022

To ERISA carrier paying lien

 

08-023

To Creditor paying lien or judgment

Medicare

08-024

CMS authorization

 

08-025

Request for conditional amount/demand letter

OCA

08-026

Closing statement

 

08-027

Letter enclosing closing statement

 

 

 

 

Appeals

 

Appellate Division

09-001

Notice of Appeal

 

09-002

Notice of Motion

 

09-003

Order to Show Cause

 

09-004

Attorney's Affirmation

 

09-005

Record on Appeal Cover page

 

09-006

Appellant's Brief Cover Page

 

09-007

CPLR 5531 Statement

 

09-008

Pre-Argument Statement-1st Department

 

09-009

Request For Appellate Division Intervention (RADI)-2nd Dept

 

09-010

Pre-Calendar Statement-3rd Department

 

09-011

Affidavit of Service

Court of Appeals

09-012

Motion for Leave to Appeal

 

09-013

Affirmation in Support of Motion for Leave

 

 

 

 

Worker's Compensation

 

10-001

Employee's Claim for Worker's Compensation (C-3)

 

10-002

Spanish Information Sheet for C-3

 

10-003

Attending Doctor's Report (C-4)

 

10-004

C-4 Continuation Form-additional billing codes/treatment dates

 

10-005

Attending Ophthalmologists Report (c-5)

 

10-006

Affidavit for Death Benefits-Spouse or Child (AFF-1)

 

10-007

Affidavit for Death Benefits-Sibling (AFF-2)

 

10-008

Affidavit for Death Benefits-Parent or Grandparent (AFF-3)

 

10-009

Application for Advance on Periodic Payments (C-21)

 

10-010

Re-opener Application (C-25)

 

10-011

Settlement Agreement (C-32)

 

10-012

Release (C-32.1)

 

10-013

Death Case Claim (C-64)

 

10-014

Proof of Burial and Funeral Expenses (C-65)

 

10-015

Records of Hearing Loss Proof (C-72.1)

 

10-016

Notice of Third Party Action

 

10-018

Claimant's Records of Medical/Travel Expenses (C-257)

 

10-019

Disability Benefits Claim Form (DB-300)

 

10-020

Attending Doctor's Request for Authorization (MD-1)

 

10-021

Claimant's Authorization to Release WC Records (OC-110A)

 

10-022

Notice of Retainer/Substitution (OC-400)

 

10-023

Attorney Fee Application (OC-400.1)

 

10-024

Statement on Disputed Issues (PH-16.2)