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For personal injury firms that need a new-client intake questionnaire. Choose the case types you handle, such as motor vehicle accidents or dog bites, and the sections you want; get a form with a conflicts check and an attorney screening summary to copy, download as Markdown or print. Free, no account, no usage limit. Your choices stay in this browser tab.
Requirements: a current web browser with JavaScript. There is nothing to install, and the form appears as soon as you select Build intake form. The only inputs are checkboxes and an optional firm name of up to 120 characters.
The personal injury intake form builder assembles a new-client intake questionnaire from fixed question lists written by Gavel. It uses no AI: the same choices always give the same form. Each question has its text, an answer type (short answer, long answer, date, yes/no, number, phone, email, or a list of choices) and, where useful, help text for the client and a follow-up note for whoever runs the intake, such as "If yes, ask for the police agency and the report number."
The form opens with a short note to the client that names your firm, says that sharing the information does not by itself make the firm their lawyer, and asks them to keep documents and not post about the incident online. Sections are numbered in this order, and each case type you choose adds its own questions under a heading such as "For motor vehicle accident cases":
| Section | Questions in every form | Added by case type |
|---|---|---|
| Contact and conflicts check (always included) | 10 contact questions, then a conflicts check with 4 questions | 2 to 3 names per case type, e.g. other driver, vehicle owner and the driver's employer |
| Incident details | 4: date, time, place, what happened | 4 to 6 per case type |
| Injuries and treatment | 8 | 1 each for medical malpractice and dog bite |
| Insurance | 5 | 4 for motor vehicle; 1 each for premises, workplace and dog bite |
| Employment and lost wages | 6 | 1 for workplace |
| Prior claims and injuries | 4 | None |
| Witnesses and evidence | 5 | 2 for motor vehicle; 1 each for premises, medical malpractice, workplace and product liability |
| Statute-of-limitations screening dates | 4: age at the incident, government involvement, deadlines mentioned, another lawyer | 2 for medical malpractice; 1 each for workplace and product liability |
| Referral source | 2 | None |
The attorney screening summary is always added at the end, marked for office use: case types, date of incident, date of intake, days since incident, whether the client was under 18, whether a government entity is involved, the discovery date (for medical malpractice or product liability), who cleared the conflicts check, and who checked the statute of limitations. It ends with a general reminder to check the statute of limitations and any notice-of-claim deadline, plus one reminder per case type, for example to check whether the state has a no-fault (PIP) system for a motor vehicle accident. This version lists no state deadlines.
The printable .html form has an answer field for each question (lines for text, boxes for choices, date fields) and no submit button. When both dates are entered on screen, it fills in the days since incident; on paper, you count them.
Example (fictional firm): Larkspur & Vance Injury Law, case type Motor vehicle accident, all sections on. This is the "Motor vehicle accident intake" sample in the builder. The result: 9 client sections, 67 questions, plus the attorney screening summary. What the motor vehicle choice adds:
Copy or download the questionnaire, edit it, and have a lawyer at your firm review it. The free intake form builder stops at a blank template. When you want clients to fill in intake online, Gavel Workflows is Gavel's no-code platform for client intake and document automation: logic-based questionnaires that clients complete on a computer or phone, with the answers stored and fed into your document templates. Plans and prices are on Gavel pricing.
Built and maintained by Gavel. Question set v1.0. Last updated November 14, 2026.
No. The builder makes a blank questionnaire and never collects a client's answers. Your choices and firm name stay in this browser tab, the builder sends them nowhere, and they are gone when you close the tab. The downloadable HTML form has no submit button, so answers typed into it stay in that file on your computer.
Yes, it is free, with no account, no email address and no usage limit. It runs in a current web browser with JavaScript, and the questionnaire appears as soon as you select Build intake form.
No. This version of the personal injury intake form builder lists no state deadlines. Its attorney screening summary records the date of incident, the date of intake, the days since incident and who checked the deadline, and reminds you to check the statute of limitations and any notice-of-claim deadline that applies in the state and to the claim.
Yes, after you download them. The builder's question lists are fixed, so download the Markdown or HTML file and edit it in a text editor, or paste the Markdown into your word processor or intake system.
Yes. Choose more than one case type and each adds its own questions under a heading such as "For dog bite cases", its own names in the conflicts check, and its own reminder in the screening summary.
No. It assembles the questionnaire from fixed question lists and rules written by Gavel, so the same choices always produce the same form. Nothing is generated by a language model.
