What type of accident were you in?
This helps us understand the circumstances and how liability is typically assessed.
Who was responsible for the accident?
Your honest read of the situation — we’ll dig into the details with you later.
Did you receive medical treatment?
Pick the highest level of care you received. This is one of the strongest signals in a claim.
What do you already have on file?
Select everything that applies. Don’t worry if your list is short — that’s exactly what this is for.
Where were you injured?
Select all areas that apply on the figure or the list.
When did the accident happen?
Timing can affect deadlines that apply to your claim.
Where should we send your report?
Your information stays confidential and is only used to follow up on your evaluation.
Reviewing your file
Calculating your case readiness score…
Your report has been sent to our office
Someone from Rourke & Associates will follow up shortly to discuss your evaluation. No obligation, no cost.
This tool does not provide legal advice and does not determine case outcomes. It is intended to help you organize information about a potential injury claim before speaking with an attorney. Submitting this form does not create an attorney-client relationship.