Representing the Personal Injury Plaintiff in NY


# This form is new or has been changed since the prior edition
Please click on the links below to view a sample of the first page of the forms listed.  Sample forms are for illustrative purposes only.  The current versions of these forms are available upon purchase.




A. Intake and Client Retention

PI001Sample Client Interview Sheetpdf (1 page)
PI002Statement of Client’s Rightspdf (2 pages)
PI003Statement of Client’s Responsibilitiespdf (1 page)
PI004Judicial Conference Retainer Statementpdf (1 page)
PI039New Language for Retainer to Incorporate New Rules in Personal Injury Retainer Agreementspdf (1 page)

B. Investigation and Securing of Medical and Other Records

PI005HIPAA Compliant Unlimited Authorization for Plaintiff’s Counsel to Secure Client’s Recordspdf (1 page)
PI007Letter from Plaintiff’s Counsel to Doctor’s Office Explaining HIPAA, Enclosing HIPAA Compliant Authorization, and Detailing What Is Being Requestedpdf (1 page)
PI007APlaintiff’s Arons/Porcelli Speaking Authorization for Defendantspdf (1 page)

C. Automobile Negligence and Insurance Related Forms

PI008Underinsured/Uninsured Notification Letterpdf (1 page)
PI009Sample New York No-Fault Computation Sheetpdf (1 page)
PI010Request for Driving Abstractpdf (1 page)
PI011Letter of Representation to Defendant Owner and Driverpdf (1 page)
PI012Pre-Suit Demand Letter for Insurance Information Under Insurance Law 
§ 3420(f)(2)(A)
pdf (1 page)

D. Commencing the Litigation

PI035Court Summonspdf (1 page)
PI013Certificate of Merit (No Issue with Statute of Limitations) for Medical Malpractice Actionpdf (1 page)
PI014Verified Summons and Complaint in a Medical Malpractice Action Involving Wrongful Death of an Infant with Attorney Verificationpdf (1 page)
PI015Notice of Commencement of Medical Malpractice Actionpdf (1 page)
PI016Verified Summons and Complaint in an Automobile Negligence Case for Individual Plaintiff and Attorney Verificationpdf (1 page)
PI040Statement of Service by Mail and Acknowledgement of Receipt by Mail of Summons and Complaintpdf (1 page)

E. Discovery and Amplification of Pleadings

PI017Plaintiff’s Verified Bill of Particulars in a Medical Malpractice Action Involving Wrongful Death of an Infantpdf (1 page)
PI018Plaintiff’s Notice of Availability for Physical Examinationpdf (1 page)
PI019Plaintiff’s Notice to Admitpdf (1 page)
PI020Plaintiff’s General Combined Demands with a Demand for a Verified Bill of Particulars on Defendant’s Affirmative Defensespdf (1 page)
PI021Plaintiff’s Notice to Produce Documents in a Product Defect Case with Jurisdictional and Successor Liability Issues as to Certain Defendantspdf (1 page)
PI021APlaintiff’s Combined Discovery Demands and Notice for Discovery and Inspection in Medical Malpractice Casepdf (1 page)
PI036Notice of Issue, Certificate of Readiness and Verificationpdf (1 page)
PI037Certificate of Readiness and Verificationpdf (1 page)
PI038Deposition Exhibit Logpdf (1 page)

F. Trial and Verdict

PI022Trial Exhibit List (Internal Use Only)pdf (1 page)
PI023Trial Notebook Index (Internal Use Only)pdf (1 page)
PI024Jury Selection Record (Internal Use Only)pdf (1 page)
PI025Trial Schedulepdf (1 page)
PI026Plaintiffs’ Request to Charge in a Medical Malpractice Casepdf (1 page)
PI027Plaintiff’s Request to Charge in a Motor Vehicle Negligence Casepdf (1 page)
PI028Plaintiffs’ Proposed Verdict Sheet in a Medical Malpractice Casepdf (1 page)

G. Settlement and Closing of Case

PI029General Releasepdf (1 page)
PI030Standard Stipulation of Discontinuancepdf (1 page)
PI031CPLR 5003-a Letter to Defendant Transmitting Settlement Documentspdf (1 page)
PI032Judicial Conference Closing Statementpdf (1 page)
PI033Client Disbursement Accountingpdf (1 page)
PI034Trial Preparation Checklistpdf (1 page)