Overview

An important part of any lawsuit is getting to know the injured person through friends and family. There are fact/eyewitnesses who saw evidence of abuse or neglect and there are also character witnesses that can speak about the injured person’s character and how they impacted their lives and the world.  Character witnesses do not have to be someone who was physically present in the nursing home.

We would like you to include as many potential witnesses as possible. Not all witnesses may be called and some witnesses may be called for an interview but may not be used as a witness if the case is filed. It is better to have too many witnesses than too few witnesses.

The witnesses you provide on this form will be contacted by our expert interviewer and interviewed about the nursing home and the injured person.  You should contact the witnesses ahead of time to let them know we will be calling to interview them.

Instructions

Fill out the section that pertains to extended family members that were related to the injured person. Extended family members include aunt, uncle, niece, nephew, cousin, stepchildren, stepparents, 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.

Next, fill out the section that pertains to friends of the injured person.

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.

Extend Family Members and Friends

Your Information

Name of the injured person
Extended family members includes niece, nephews, aunts, uncles, stepchildren, stepparents, cousins, siblings-in-law

Extended Family Members

Cell phone if possible
Address
Line 1
Line 2
City
State/Province
Zip/Postal
Country
We need to have an address, phone number and email for each person. If yo do not have all the information, what is the name and phone number of the person that does have their full contact information?
Check all that apply
Be candid
How would you describe their relationship? Close, distant, strained, estranged? Why? Please give as much detail as you think is important.