Instructions
Fill out the below sections that pertain to different family members that were related to the injured person. Each section is for a specific family member, e.g., section one is just for the spouse of the injured person, section 2 should list only children of the injured person, etc.
Remember, you are entering the family members of the injured person and how they are related to the injured person, not how they relate to you.
Fill in your name in the section that applies to you–such as if you are the spouse or a child.
Put in all the information you have or can obtain. Do not leave anyone off the list, even if you do not have their contact information. You can add any concerns or questions you have to the “Anything Else?” question at the end.
There may be sections that do not apply. You can leave those blank.
It is important that we identify who the family members are for many reasons. First we need to know who the injured person was and that means who were the family members in their life. If the injured person is deceased, an estate must be open in probate court and the immediate family members will have to be named and put on notice that an estate is being opened. For estate purposes, include all family members even if they are deceased.
Families are also great witnesses because they had direct and indirect contact with the injured person. It does not matter if you think they might be a good or bad witness or have been estranged from the family. We need to know about all family members. If there was a problem in the relationship or you believe that they had a great relationship, please let us know in the appropriate area for each family member.