MMG LAW FIRM · KEEP WITH YOUR RECORDS
Accident loss-record worksheet
Organize information you already have. This worksheet does not estimate compensation or establish that every listed loss is recoverable.
Accident date, location, and report number
Medical providers, treatment, and available bills
Missed work and changes in duties
Future care or lasting limitations discussed by providers
Household tasks affected and help received
Daily-life changes and symptoms
Damaged property and transportation records
Insurance offers, notices, and questions about deductions
Questions: What proof is missing? Are any losses overlapping? What future needs are supported? What could affect my net recovery?
Keep completed notes securely. This handout does not collect or transmit information.