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North Texas Reports |
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Case Report Form |
You have various
options for submitting case information.
- Print the form, fill it out by hand or type it, and fax or mail.
- Leave the form blank, adding your prepared case report information as an attachment.
- Fill out the form online and submit without reviewing, adding attachments if desired.
- Fill out the form online, print before submitting, modify as desired and submit,
adding attachments if desired.
Check the appropriate box:
Submitted by (name and phone no.):
Case No:
Court:
County:
Complete Case Caption:
Plaintiff Counsel, Firm Name, and Phone No.:
Defense Counsel, Firm Name, and Phone No.:
Plaintiff Experts:
(name, city, & state, expertise, and live, video or depo appearance or affidavit):
Defense Experts:
(name, city, & state, expertise, and live, video or depo appearance or affidavit):
Case Description (fact situation, dates, etc.):
Allegations & Defenses:
(Personal Injury Cases Only)
Age, Marital Status, Income, Injuries, Treatment & Specials of Plaintiff/Decedent:
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Information Specific to Report of Verdict
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Verdict Outcome, Jury Vote & Damages:
Judge:
Trial Length:
Jury Deliberation Time:
Jury Mix (male/female):
Settlement Negotiations:
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Information Specific to Report of Settlement
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Settlement Amount:
Details of Payout (cash/cost of structure, etc.):
Mediator Name & City & State
(Settled in Mediation Only)
Other Comments:
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