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

PI001 Sample Client Interview Sheet pdf (1 page)
PI002 Statement of Client’s Rights pdf (2 pages)
PI003 Statement of Client’s Responsibilities pdf (1 page)
PI004 Judicial Conference Retainer Statement pdf (1 page)
PI039 New Language for Retainer to Incorporate New Rules in Personal Injury Retainer Agreements pdf (1 page)

B. Investigation and Securing of Medical and Other Records

PI005 HIPAA Compliant Unlimited Authorization for Plaintiff’s Counsel to Secure Client’s Records pdf (1 page)
PI007 Letter from Plaintiff’s Counsel to Doctor’s Office Explaining HIPAA, Enclosing HIPAA Compliant Authorization, and Detailing What Is Being Requested pdf (1 page)
PI007A Plaintiff’s Arons/Porcelli Speaking Authorization for Defendants pdf (1 page)

C. Automobile Negligence and Insurance Related Forms

PI008 Underinsured/Uninsured Notification Letter pdf (1 page)
PI009 Sample New York No-Fault Computation Sheet pdf (1 page)
PI010 Request for Driving Abstract pdf (1 page)
PI011 Letter of Representation to Defendant Owner and Driver pdf (1 page)
PI012 Pre-Suit Demand Letter for Insurance Information Under Insurance Law 
§ 3420(f)(2)(A)
pdf (1 page)

D. Commencing the Litigation

PI035 Court Summons pdf (1 page)
PI013 Certificate of Merit (No Issue with Statute of Limitations) for Medical Malpractice Action pdf (1 page)
PI014 Verified Summons and Complaint in a Medical Malpractice Action Involving Wrongful Death of an Infant with Attorney Verification pdf (1 page)
PI015 Notice of Commencement of Medical Malpractice Action pdf (1 page)
PI016 Verified Summons and Complaint in an Automobile Negligence Case for Individual Plaintiff and Attorney Verification pdf (1 page)
PI040 Statement of Service by Mail and Acknowledgement of Receipt by Mail of Summons and Complaint pdf (1 page)

E. Discovery and Amplification of Pleadings

PI017 Plaintiff’s Verified Bill of Particulars in a Medical Malpractice Action Involving Wrongful Death of an Infant pdf (1 page)
PI018 Plaintiff’s Notice of Availability for Physical Examination pdf (1 page)
PI019 Plaintiff’s Notice to Admit pdf (1 page)
PI020 Plaintiff’s General Combined Demands with a Demand for a Verified Bill of Particulars on Defendant’s Affirmative Defenses pdf (1 page)
PI021 Plaintiff’s Notice to Produce Documents in a Product Defect Case with Jurisdictional and Successor Liability Issues as to Certain Defendants pdf (1 page)
PI021A Plaintiff’s Combined Discovery Demands and Notice for Discovery and Inspection in Medical Malpractice Case pdf (1 page)
PI036 Notice of Issue, Certificate of Readiness and Verification pdf (1 page)
PI037 Certificate of Readiness and Verification pdf (1 page)
PI038 Deposition Exhibit Log pdf (1 page)

F. Trial and Verdict

PI022 Trial Exhibit List (Internal Use Only) pdf (1 page)
PI023 Trial Notebook Index (Internal Use Only) pdf (1 page)
PI024 Jury Selection Record (Internal Use Only) pdf (1 page)
PI025 Trial Schedule pdf (1 page)
PI026 Plaintiffs’ Request to Charge in a Medical Malpractice Case pdf (1 page)
PI027 Plaintiff’s Request to Charge in a Motor Vehicle Negligence Case pdf (1 page)
PI028 Plaintiffs’ Proposed Verdict Sheet in a Medical Malpractice Case pdf (1 page)

G. Settlement and Closing of Case

PI029 General Release pdf (1 page)
PI030 Standard Stipulation of Discontinuance pdf (1 page)
PI031 CPLR 5003-a Letter to Defendant Transmitting Settlement Documents pdf (1 page)
PI032 Judicial Conference Closing Statement pdf (1 page)
PI033 Client Disbursement Accounting pdf (1 page)
PI034 Trial Preparation Checklist pdf (1 page)