{"id":5070,"date":"2020-12-06T17:12:00","date_gmt":"2020-12-06T21:12:00","guid":{"rendered":"https:\/\/joemillerinjurylaw.com\/?page_id=5070"},"modified":"2022-02-01T10:13:37","modified_gmt":"2022-02-01T14:13:37","slug":"free-online-car-accident-case-evaluation","status":"publish","type":"page","link":"https:\/\/joemillerinjurylaw.com\/free-online-car-accident-case-evaluation\/","title":{"rendered":"Free Online Car Accident Case Evaluation"},"content":{"rendered":"<h3>Get a Free Online Car Accident Case Evaluation<\/h3>\n<p>Were you injured in a car accident and aren\u2019t sure what to do? Contact us before you speak to the insurance companies! We protect your rights!<\/p>\n<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_19' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_19'  action='\/wp-json\/wp\/v2\/pages\/5070' data-formid='19' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_19' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_19_33\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_33\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_19_33'>\n                            \n                            <span id='input_19_33_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_33.3' id='input_19_33_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_19_33_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_19_33_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_33.6' id='input_19_33_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_19_33_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_19_4\" class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_4\" ><label class='gfield_label gform-field-label' for='input_19_4'>Best phone number to reach you<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_19_4' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_45\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_45\" ><label class='gfield_label gform-field-label' for='input_19_45'>Date of birth<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_45' id='input_19_45' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_19_45_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_19_45_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_19_45' class='gform_hidden' value='https:\/\/joemillerinjurylaw.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_19_2\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_2\" ><label class='gfield_label gform-field-label' for='input_19_2'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_19_2' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_19_20\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_20\" ><label class='gfield_label gform-field-label' for='input_19_20'>Date of Accident<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_20' id='input_19_20' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_19_20_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_19_20_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_19_20' class='gform_hidden' value='https:\/\/joemillerinjurylaw.com\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_19_14\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_14\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Location of accident<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city ginput_container_address gform-grid-row' id='input_19_14' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_19_14_1_container' >\n                                        <input type='text' name='input_14.1' id='input_19_14_1' value=''    aria-required='true'    \/>\n                                        <label for='input_19_14_1' id='input_19_14_1_label' class='gform-field-label gform-field-label--type-sub '>Street<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_19_14_3_container' >\n                                    <input type='text' name='input_14.3' id='input_19_14_3' value=''    aria-required='true'    \/>\n                                    <label for='input_19_14_3' id='input_19_14_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_14.4' id='input_19_14_4' value='Virginia'\/><input type='hidden' class='gform_hidden' name='input_14.6' id='input_19_14_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_19_34\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_34\" ><label class='gfield_label gform-field-label' for='input_19_34'>Provide a brief description of the accident:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_34' id='input_19_34' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_19_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_23\" ><label class='gfield_label gform-field-label' >Was the responsible driver charged and issued a summons by the Police?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_23'>\n\t\t\t<li class='gchoice gchoice_19_23_0'>\n\t\t\t\t<input name='input_23' type='radio' value='Yes'  id='choice_19_23_0'    \/>\n\t\t\t\t<label for='choice_19_23_0' id='label_19_23_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_23_1'>\n\t\t\t\t<input name='input_23' type='radio' value='No'  id='choice_19_23_1'    \/>\n\t\t\t\t<label for='choice_19_23_1' id='label_19_23_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_23_2'>\n\t\t\t\t<input name='input_23' type='radio' value='Not Sure'  id='choice_19_23_2'    \/>\n\t\t\t\t<label for='choice_19_23_2' id='label_19_23_2' class='gform-field-label gform-field-label--type-inline'>Not Sure<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_26\" ><label class='gfield_label gform-field-label' >Did you obtain appropriate insurance information from the responsible party?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_26'>\n\t\t\t<li class='gchoice gchoice_19_26_0'>\n\t\t\t\t<input name='input_26' type='radio' value='Yes'  id='choice_19_26_0'    \/>\n\t\t\t\t<label for='choice_19_26_0' id='label_19_26_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_26_1'>\n\t\t\t\t<input name='input_26' type='radio' value='No'  id='choice_19_26_1'    \/>\n\t\t\t\t<label for='choice_19_26_1' id='label_19_26_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_28\" ><label class='gfield_label gform-field-label' >How would you Describe Damage to the Car you were in at the time of the accident?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_28'>\n\t\t\t<li class='gchoice gchoice_19_28_0'>\n\t\t\t\t<input name='input_28' type='radio' value='Mild'  id='choice_19_28_0'    \/>\n\t\t\t\t<label for='choice_19_28_0' id='label_19_28_0' class='gform-field-label gform-field-label--type-inline'>Mild<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_28_1'>\n\t\t\t\t<input name='input_28' type='radio' value='Moderate'  id='choice_19_28_1'    \/>\n\t\t\t\t<label for='choice_19_28_1' id='label_19_28_1' class='gform-field-label gform-field-label--type-inline'>Moderate<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_28_2'>\n\t\t\t\t<input name='input_28' type='radio' value='Severe (totaled)'  id='choice_19_28_2'    \/>\n\t\t\t\t<label for='choice_19_28_2' id='label_19_28_2' class='gform-field-label gform-field-label--type-inline'>Severe (totaled)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_28_3'>\n\t\t\t\t<input name='input_28' type='radio' value='I was a pedestrian, not in a vehicle'  id='choice_19_28_3'    \/>\n\t\t\t\t<label for='choice_19_28_3' id='label_19_28_3' class='gform-field-label gform-field-label--type-inline'>I was a pedestrian, not in a vehicle<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_41\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_41\" ><label class='gfield_label gform-field-label' for='input_19_41'>Please describe the injuries you suffered in the accident:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_41' id='input_19_41' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_19_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_31\" ><label class='gfield_label gform-field-label' >Please choose one of the following to rate the severity of your injuries from the accident:<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_31'>\n\t\t\t<li class='gchoice gchoice_19_31_0'>\n\t\t\t\t<input name='input_31' type='radio' value='Mild'  id='choice_19_31_0'    \/>\n\t\t\t\t<label for='choice_19_31_0' id='label_19_31_0' class='gform-field-label gform-field-label--type-inline'>Mild<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_31_1'>\n\t\t\t\t<input name='input_31' type='radio' value='Moderate'  id='choice_19_31_1'    \/>\n\t\t\t\t<label for='choice_19_31_1' id='label_19_31_1' class='gform-field-label gform-field-label--type-inline'>Moderate<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_31_2'>\n\t\t\t\t<input name='input_31' type='radio' value='Severe (Had surgery or surgery planned)'  id='choice_19_31_2'    \/>\n\t\t\t\t<label for='choice_19_31_2' id='label_19_31_2' class='gform-field-label gform-field-label--type-inline'>Severe (Had surgery or surgery planned)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_19\" ><label class='gfield_label gform-field-label' >Have you been seen at a hospital or doctor\u2019s office since the accident?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_19'>\n\t\t\t<li class='gchoice gchoice_19_19_0'>\n\t\t\t\t<input name='input_19' type='radio' value='Yes'  id='choice_19_19_0'    \/>\n\t\t\t\t<label for='choice_19_19_0' id='label_19_19_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_19_19_1'>\n\t\t\t\t<input name='input_19' type='radio' value='No'  id='choice_19_19_1'    \/>\n\t\t\t\t<label for='choice_19_19_1' id='label_19_19_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_38\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_38\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Are you currently treating for your injuries?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_38'><li class='gchoice gchoice_19_38_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.1' type='checkbox'  value='Yes'  id='choice_19_38_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_38_1' id='label_19_38_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_19_38_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.2' type='checkbox'  value='No'  id='choice_19_38_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_19_38_2' id='label_19_38_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_42\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_19_42\" ><label class='gfield_label gform-field-label' >Do you have health insurance?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_19_42'>\n\t\t\t<li class='gchoice gchoice_19_42_0'>\n\t\t\t\t<input name='input_42' type='radio' value='Yes'  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