Claim Form - Slip and Fall (Commercial Property)

This Claim Form for a Slip and Fall on Commercial Property is for use by an attorney representing a client or an individual who received injuries as a result of a slip and fall while on commercial property. This claim form will serve as formal notice of the injury and is sent to the business where the fall occurred. This form contains pertinent information regarding the accident including where it occurred, date of occurrence, the facility where treatment was received and names of treating physicians. It also contains a description of the injured party and how the slip and fall has affected their life. It is vital that all details regarding this type of injury be set out in writing. A written Claim Form after a Slip and Fall on Commercial Property acts as formal notice of a claim and will be helpful if litigation is filed.

This Claim Form – Slip and Fall (Commercial Property) includes the following:

• Business/Registered Agent: Sets out the name and address of the business where the injury occurred;
• Injury: Detailed description of the incident including the date, how the slip and fall happened and location in the business where the injury occurred;
• Treating Hospital/Physician: Description of treatment received, name of attending physician, medications prescribed and follow-up instructions;
• Follow-Up Treatment: Follow-up doctor visits or physical therapy necessitated by the injury;
• Description of Injured Party: A short synopsis about how the injury has changed the party’s life (absence from work, inability to perform household chores and economic hardships);
• Demand for Damages: Demand for damages including payment for lost wages, medical expenses and mental anguish;
• Signature: The claim form must be signed by the attorney or individual who suffered the injury.

This attorney-prepared packet contains:

1. General Information and Checklist
2. Claim Form – Slip and Fall (Commercial Property)

State Law Compliance: This form complies with the laws of all states

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• Includes:

  √ Free Checklist

• State:

   All
  

  Number of Pages:

   6

• File Types Included:

  
  √ Microsoft Word
  √ Adobe PDF
  √ WordPerfect
  √ Rich Text Format
  

• Compatible with:

  Windows and Mac OS