Worksheet

Personal injury case file checklist

The checklist fits one page and has five blocks: intake, providers, liens, demand and settlement. The provider block has columns for name, first visit, last visit, records requested and records received. The lien block lists claimant, amount, notice date and payoff status. The settlement block sets out gross, costs, liens and net to client.

Name: ______________________   Business: ______________________   Date: ______________

Scroll the table sideways to see every column.

Cross out or rewrite any heading that does not fit your business. From the guide “Personal Injury Case File Checklist From Intake to Settlement”, www.gullysystem.com/blog/personal-injury-case-file-checklist-from-intake-to-settlement