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Request Case Evaluation Report

 
 
 5-day service: $190
2-day service: $85 extra
1-day service: $100 extra
How did you hear about Jury Verdict Research®?
 
JVR Case Evaluation provides a custom valuation based on the specific facts of your case.
To fill out the order form below, you will need the following information about your case:

   • Injury and liability details
   • Medical expenses (except for death cases)
   • Plaintiff and defendant demographic information
 
Probable Location of Trial:
 Yes  No
 Yes  No


  Please include sufficient information so we can determine the nature of the liability.

Party Characteristics (Complete both Plaintiff and Defendant sections)

Plaintiff or Decedent Characteristics
 Male  Female
  Including adult children.
 Yes  No
 Yes  No
 Yes  No
 Yes  No
 Yes  No
 Yes  No
 

Defendant(s) Characteristics
 Yes  No
  Choose the most important one.
  A general description will suffice.
 Yes  No
 Yes  No
 Yes  No
 Yes  No
 
Medical Expenses and Wage Loss (Include medical expenses even if paid by third party)
Medical Expenses: Only medical expenses to probable date of trial are required. Lost Earnings:
$ $
 Yes  No  Yes  No
$ $
 Yes  No  Yes  No


Injuries Not Resulting in Death
Injury Info (list most serious injury first) % Perm. Impairment  If applicable, Plaintiff’s doctor will determine percentage of permanent impairment using guidelines issued by the American Medical Association.
1.
  Is this injury contested by defendants?
        Denial of This Injury  Yes  No
        Impairment Contested  Yes  No
        Injury Unrelated to Incident  Yes  No
  Is there scarring?  Yes  No
  Is the scarring a result of surgery?  Yes  No
 
2.
3.
4.
5.
 
    Check this box if the injured party has suffered prolonged pain (localized to the injured body part) as a secondary condition.
    Check this box if you contend that the injury is the result of an intentional act with the express purpose to harm, rather than the result of an accident.

 
 
Witnesses (Need help locating an expert witness for your case? Click here!)
Type of Witness Side
 
 
 
 
 
 
 
 
 
 
 
 Please provide any additional details you think are important for us to know.
 
Additional Reports
 
ORDER A LOSS OF SERVICES EVALUATION (an additional $50)  This is useful in providing you a probable verdict amount and basic recovery probability for a parent or spouse for their loss of society, affection, help, comfort, guidance, or conjugal relations.
Yes      No 
 
ORDER A VERDICT FINDER AND SAVE $55 OFF THE COMBINED REPORT PRICE? (an additional $135)  A VerdictFinder report contains 20-40 jury verdicts and complements your case evaluation.
Yes      No 
 
* = Required Fields

 
 
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