Quiz - Crash Guru

1Question 1

2Question 2

3Question 3

4Question 4

5Question 5

6Question 6

7Question 7

8Question 8

9Question 9

10Question 10

11Question 11

12Question 12

13Question 13

14Question 14

15Question 15

16Question 16

17Question 17

18Finished

Question 1. Welcome

First Name(Required)

Last Name(Required)

Question 2. What state was the accident in?

What state was the accident in?

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(877) 799-3111

Question 3. When was the car accident?

When?

MM slash DD slash YYYY

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(877) 799-3111

Question 4. Your e-mail and phone number.

Your E-mail(Required)

Your Phone

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 5. Did you have Insurance?

Did you have Insurance?

Yes

Not sure

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 6. Who is your insurance provider?

Who is your insurance provider?

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 7. Do you know who was at fault?

Do you know who was at fault?

Yes

Not sure

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(877) 799-3111

Question 8. Were you hurt?

Were you hurt?

Yes

Not sure

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(877) 799-3111

Question 9. Do you or anyone in the car have neck or back pain?

Do you or anyone in the car have neck or back pain?

Yes

Not sure

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 10. Do you or anyone in the car break a bone?

Do you or anyone in the car break a bone?

Yes

Not sure

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 11. Do you or anyone in the car have head or brain injuries?

Do you or anyone in the car have head or brain injuries?

Yes

Not sure

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 12. Did anyone in the car pass away?

Did anyone in the car pass away?

Yes

Not sure

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 13. Have you gone to the doctor, chiropractor, or physical therapist for these issues/pains?

Have you gone to the doctor, chiropractor, or physical therapist for these issues/pains?

Yes

Not sure

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 14. Was there anyone else in the car?

Was there anyone else in the car?

Yes

Not sure

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 15. Was there are police report? Did the police come to the scene of the accident?

Was there are police report? Did the police come to the scene of the accident?

Yes

Not sure

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 16. What is your address?

What is your address?

Don’t want to answer? Schedule a call with Guru!
(877) 799-3111

Question 17. Brief notes on the description of the accident.

Brief notes on the description of the accident.

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(877) 799-3111

You have finished your quiz. Send the results to a Guru