Most problems in a personal injury case start at the front desk. A lien nobody signed, an attorney who turns out not to represent the patient, a missing date of injury, a records request with no authorization behind it. Each one is cheap to prevent on day one and expensive to fix at settlement.
This personal injury intake checklist is for front desk staff, office managers and practice owners. It covers what to collect before or at the first visit, why each item matters later, and what to verify before you treat on a lien.
This is general information, not legal advice. Intake forms, lien terms and consent requirements vary by state and practice. Have your forms reviewed by a licensed attorney in your state.
What should a personal injury intake collect?
A personal injury intake should collect the accident details, the injuries and symptoms in the patient's words, prior injuries and treatment, the attorney and law firm, any insurance or claim information, and signed consent, lien and records authorization forms. Collect it before the first visit if you can, so the first exam starts from a complete case.
The personal injury intake checklist
| Collect | Details | Why it matters later |
|---|---|---|
| Patient demographics | Legal name, date of birth, contact details, preferred contact method | Every record, bill and release has to match the right patient |
| Accident details | Date of injury, type of accident, how it happened, where they were in the vehicle, police report number if any | Ties treatment to the injury claimed in the case |
| Rideshare or delivery driver involved? | Yes or no, and which company | Some states now apply different rules to these cases, such as California SB 623 from 2027 |
| Symptoms and limitations | Where it hurts, when symptoms started, what the patient can no longer do | Sets the baseline that every later visit is compared with |
| Prior injuries and treatment | Earlier injuries or treatment to the same body area, other providers seen since the accident | The other side will look for pre-existing conditions. Better to know first. |
| Attorney and law firm | Attorney name, firm, case manager, phone and email | Requests, updates and payment all go through the firm |
| Claim information | Auto insurer, claim number, adjuster contact if known | Needed for records requests and some billing |
| Health coverage | Health insurance, and any auto medical coverage such as PIP or MedPay | Decides how the visit is billed, and some states require disclosure of coverage in lien cases |
| Signed consent to treat | Your standard consent forms | Required before treatment |
| Signed lien or letter of protection | The patient's signature, plus the attorney's if your form requires it | The basis for waiting to be paid from the settlement |
| Records authorization | A HIPAA authorization naming the law firm, what may be shared, and an expiration | A lien is not a records release. Without the authorization you can't send records to the firm. |
| Financial terms and attendance policy | What the patient owes if the case is lost or dropped, and the missed-visit policy, both acknowledged in writing | Avoids disputes at the end of the case |
What should staff verify before treating on a lien?
Before the first visit on a lien, confirm that the attorney actually represents the patient, that the lien is signed by everyone your form requires, and that the records authorization names the right firm. Five minutes of checking at intake prevents months of chasing later.
- Representation. Ask the firm to confirm in writing that it represents the patient for this accident, and get the case manager's direct contact.
- Signatures. Check that the patient, and the attorney if required, have signed the lien or letter of protection. A lien missing a signature is a weak position at settlement.
- Authorization scope. Make sure the HIPAA authorization names the firm and covers the records the firm will ask for (45 CFR 164.508).
- Coverage. Verify any health insurance or auto medical coverage the patient has, so billing decisions are made on day one.
- Referral source. Record who referred the patient. In Florida, for example, a claimant treated under a letter of protection must disclose whether they were referred and by whom (Florida Statutes § 768.0427).
