Anand Desai Law Firm — Start Your Car Accident Case

Let's get you back
on the road.

Sorry you're going through this — we've got it from here. This takes about 5–7 minutes, and you can skip anything you're not sure about.

If this is a medical emergency, call 911 first — this form can wait.

Fields marked with * are required — everything else is optional, but the more you can share, the more it helps your case. If something doesn't apply to you, just type N/A.

A quick word from Anand

Before we get into the details, take a minute to hear directly from Anand about what to expect and how we'll take care of you.

First, a little about you

So we know who we're cheering for — and how to reach you.

Full name

Date of birth

Current address

Cell number

Email address

Best way to reach you

Preferred language

Please tell us your preferred language

Marital status

This helps us evaluate whether your spouse may also have a claim.

Employer / occupation

Tell us about the accident

Just the basics — best guesses are perfectly okay.

Date it happened

This is required, and can't be a date in the future.

Around what time?

Uses 24-hour time — for example, 7:00 PM is 19:00.

Where did it happen?

Zip code

You were the...

Which direction were you heading?

What lane were you in?

About how fast were you going?

What happened, in your own words?

Did the airbags deploy?

Have you been in a car accident before this one?

Date of that accident

Were you injured?

What injuries did you have prior to the current incident?

Did you have legal representation?

Which party was at fault?

Passengers

Were there passengers in your vehicle?

How many?

The other vehicle

What kind of vehicle was the other driver in?

Commercial, rideshare, and government vehicles often mean extra insurance coverage — and sometimes shorter deadlines to file. This helps us move fast on the right track.

Company or employer name on the vehicle, if you saw one

Was the rideshare driver actively on a trip (picking up, dropping off, or carrying a passenger)?

Which government agency or department, if known

Claims against government agencies usually have a much shorter deadline — often just 6 months. We'll prioritize this right away.

Injuries & medical care

This helps us understand how you're doing — take your time.

Were you injured?

Which body part(s) are injured?

Tap all that apply.

Please tell us which body part

What injuries are there?

Have you been to an emergency room or urgent care?

Where did you receive care?

Were any passengers injured?

What injuries do the passengers have?

If there's more than one passenger, please list each as Name - injury (one per passenger).

Has the passenger been to an emergency room or urgent care?

Where did the passenger receive care?

Let's talk about your car

So we can get repairs — and a rental, if you need one — moving fast.

Make, year, and model of your vehicle

Are you the registered owner of the car?

Whose name is the car registered under?

Where is the car right now?

Is your vehicle leased or purchased?

Are you still making payments on it?

Do you have GAP coverage?

GAP coverage can cover the difference between what you owe and the car's value if it's totaled.

Is the car still driveable?

Would you like a rental vehicle?

Were there any car seats in the vehicle?

Do you have pictures of the car seat(s)?

Car seats often need replacing after a crash — this helps us include yours in the claim.

No problem — paste a link to the car seat model

The report & the receipts

Police info, claim numbers, photos — whatever you've got.

Police

Were the police called?

Was a report made?

Police report number

Insurance

Are you the policy holder?

Whose name is the policy under?

Your insurance company

Your policy number

At-fault driver's insurance company

At-fault driver's policy number

Have you received a claim number?

Claim number

Photos & videos

Were any photos taken at the scene?

Any videos?

Keep any photos, videos, or paperwork handy — you'll attach them a couple of stops ahead.

The people in your corner

Who else was there — and who we should call if we can't reach you.

Emergency contact

Their name

Their phone number

Their address

Witnesses

Were there any witnesses?

Witness name(s) and contact info

Show us what you've got

Photos, videos, documents — every bit helps your case. Nothing handy? Just roll on through.

Photo of damages and scene

The scene, the vehicle damage, your injuries — anything

Client's Driver's License *

Your license or state ID — front side is fine

Please add a photo of your driver's license.

Add photos of your license plate(s)

Your plate — and the other driver's, if you got a shot of it

Client's Insurance *

Your insurance card or declarations page

Please add your insurance card.

Client's Registration Card

Your vehicle registration card

Other party's Driver's License

The other driver's license, if you got a photo of it

Other party's Insurance

Their insurance card, if you got a photo of it

Add videos

Dashcam, doorbell, or phone clips

Add other documents

Police report, medical bills, and anything else

Tap a card to pick files from your phone — you can add several at once, and remove any with the ×.

Last stop — you made it!

One quick look before this rolls into our team's hands.

How did you hear about us?

Anything else we should know?

Submitting this form does not create an attorney-client relationship — a member of our team will follow up to talk it through. Please don't include your Social Security number or other highly sensitive ID numbers here; we'll collect anything like that securely by phone.

You made it — thank you!

Your info is in and someone from our team will reach out within one business day. If it's urgent, don't wait for us — call now and skip the line.

Call (833) 270-7800

Let's get you backon the road.