pretrial memo form completed.pdf - PRETRIAL MEMO COURT USE...

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Unformatted text preview: PRETRIAL MEMO COURT USE ONLY The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person listed at . JD-ES-47 Rev. 5-17 P.B. §§ 14-13, 14-14 Instructions Each party claiming damages or that party's attorney shall complete this form and at the beginning of the pretrial session give a copy to the judge or judge trial referee and to each other party. Attach additional sheets if necessary. NOTICE: This memo is intended for pretrial purposes only and shall not be construed as an admission against any party. (To be completed by attorney/self-represented party) PRETMEM *PRETMEM* Docket number MMX-CV-19-567890 Date April 15, 2020 Plaintiff First Defendant First Defendant's trial counsel Phone number Robert Robot Daisy Dunn Davit Protector 860-347-7654 Additional Defendant Additional Defendant's trial counsel Phone number Additional Defendant Additional Defendant's trial counsel Phone number Plaintiff's trial counsel Phone number Betty Best 860-123-4567 Intervening trial counsel Phone number Return date Date certificate of closed pleadings filed Type of claim October 16, 2019 Motor vehicle accident Trial date Have you discussed appropriate A.D.R. with your client? ✖ Yes These 2 questions to be completed by attorneys only No Does your client have any objection to a referral to non-binding A.D.R.? Yes ✖ No Date and time of accident (if applicable) December 16, 2017 at 4:30 pm Claim (e.g. Accident) The defendant, Daisy Dunn, was texting while driving her car. Daisy Dunn was driving on Happy Hill Lane in MakeBelieve, Connecticut. Daisy was so focused on her texting that she did not notice that the light had turned red at the intersection of Happy Hill Lane and Doom and Gloom Road and that the car in front of her had come to a stop. Daisy Dunn drove right into the car ahead of her, causing an accident that damaged the back end of th Intervenor's Claim Nature of damages or demand The plaintiff obtained injuries including back, neck, and shoulder sprains/strains and the back of his vehicle was smashed in. Damages or Demand (e.g. Injuries) If Applicable Last medical exam Permanency of injuries/life expectancy 50 Reason Cost Explanation Middlesex Hospital 1. Treatment expenses (for example, doctors, surgery, lab tests, MRIs, X-Rays) Specials Age of party January 8, 2020 37 years $1,500.00 Doctors bills 2. Recovery expenses (for example, hospital stays, rehabilitation centers, physical therapy, occupational therapy) $5,500.00 3. Subtotal (Add 1 & 2) $7,000.00 4. Future Medical $1,100.00 Lost wages 5. Wages $800.00 Future capacity 6. Other (Property Damage, etc.) $8,900.00 Copies of all medical bills and reports have been furnished to the Defendant(s) 7. Total 8. Liens (For example Medicare, Amount workers' compensation, ERISA) Print Form Reset Form ✖ Yes No ...
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