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Initial Client Interview Form A. CLIENT PERSONAL INFORMATIONName: Justin KingAddress: 123 Main Street, Chicago, Illinois 60601Home Phone: (913)123-4567 Work Phone: (913)890-1234Social Security Number: 123-45-6789Driver’s License Number: IL39562243Date of Birth: 7/14/83Marital Status: Single Dependents: NoneMilitary Status: N/AOccupation: Student/RetailEmployer Name, Address, Phone Number: __________________________________________________________ Membership in Union or Professional Organization: N/A Police Record (if any): N/AHave you ever filed bankruptcy? If so, please explain. N/AB. CLIENT EMPLOYMENTType of Work: Retail Sales Job Title: CashierImmediate Supervisor’s Name: Jill JanesSalary or Hourly Rate: $7.75/hourNumber of Hours Worked Weekly - Before Accident 20 - After Accident 0
Benefits (Company car, pension plan, vacation, expense account, etc.) N/A D. CLIENT’S FACTS/STORY: BE AS DETAILED AS YOU CAN BE. INCLUDE DAMAGES AND ALL NAMES TOLD BY CLIENT Mr. King says that he lives at 123 Main Street, Kansas City, Missouri not at 123 Main Street, Chicago. Mr. King also stated that on April 5th of last year that he won the National Idol regional contest in Chicago. After he won the contest he was offered a Contract with M.C.I records to become a singer. The contract was for three years with a total of $275,000. On April the 8th just three after he won the contest, Mr. King was in an accident involving his motorcycle and a big beer truck with the name coops lite or coops ultra on the side on interstate 57. Mr. King stated that the as he was driving on the left lane, the driver of the beer truck came up behind him and started to flash their lights. When Mr. King noticed the flashing lights he then proceeded to the right side of the lane. While Mr. King was driving on the right side, he started to notice some of the beer cases were coming his way and that is when he swerved back to the left side of the lane. The next thing Mr. King remembers is that he is waking up in a Paxton hospital with his jaw wired shut. When the doctor arrives in the room, tells Mr. King that he has 9 facial bone in his face that are broken and he had to stay two days in the Paxton ICU. The next day while Mr. King was in the hospital his agent call him and told him that he has to withdraw from the competition and this is when Mr. King stated that he wants to sue everyone for $100 million dollars. He then starts to loosen the wires in his jaw and a doctor and nurse notices it and comes in and tells him that he has to keep the wire in jaw,
so it would keep his face together. After that he started to get angry and the doctors gave