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Case evaluation form template

A free case review that captures the key facts. It asks for name, phone, email and city and state, plus 22 more questions. Use this free form template as it is, or change any question, the style and the thank-you screen, then share it or put it on your site.

FreeConsultationIntakeLead generation26 questions5 pages
Style
  • PaperClean and quiet
  • MidnightDark and calm
  • CoralWarm and bold
  • GroveNatural and calm
  • EditorialBig type, few lines
  • TerminalCode on black
  • BubblegumPlayful and round
  • TideFresh and light
  • PosterLoud and graphic
  • GildedBlack and gold
  • LilacSoft and friendly
  • ClayEarthy and warm
  • StudioShapes and primary colors
  • HarborTrusted and clear
  • MintBright and easy
  • RetroChunky and sunny
  • NoirDark and elegant
  • SunriseGolden and upbeat

Case evaluation

Page 1

About you

Best way to reach you

Page 2

Injury details

How were you hurt?

Did you get medical treatment?

Was a police or incident report made?

Have you talked to an insurance company?

Page 3

Family matter

What is the family matter about?

Are there children under 18?

Has anyone filed in court yet?

Page 4

Work or business

What is the work issue about?

Are you still working there?

What is the business matter about?

Is there a written contract or agreement?

Page 5

Timeline and consent

Is there a deadline or court date coming up?

Have you talked to another lawyer about this?

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    Styles

    One form, 18 looks.
    Pick one, or bring your color.

    Customize in minutes

    Make it yours.
    No code.

    Change any question, add your own from 26 question types, and show each one only when it matters.

    • Short text
    • Long text
    • Email
    • Phone
    • Website
    • Number
    • Money
    • Pick one
    • Pick many
    • Dropdown
    • Yes or no
    • Checkbox
    • Stars
    • NPS 0–10
    • Opinion scale
    • Ranking
    • Matrix
    • Date
    • Time
    • Date range
    • Full name
    • Address
    • File upload
    • Signature
    • Statement
    • Hidden

    Show-if logic

    Ask the next question only when an earlier answer calls for it.

    Pages and progress

    Split long forms into pages with a progress bar.

    Scores and results

    Turn answers into a score and show each person what it means.

    Files and signatures

    Take uploads up to 10 MB and signatures drawn on any screen.

    Booking

    Open your calendar on the thank-you screen, with name and email filled in.

    Consent by region

    An opt-in box where the law asks for one, a short notice everywhere else.

    Every answer a contact

    The company comes from the work email, the campaign from the link.

    Spam stays out

    A hidden trap, rate limits and temporary emails refused.

    Connect to any app

    Answers go where you work.
    Live in a minute.

    1. 01

      Use the form template

      It opens in Claritia ready to go, in the style you picked. Answers are linked to your contact fields and the form goes live.

    2. 02

      Connect your tools

      Send answers to HubSpot, Salesforce or Omniscient, open your calendar after a booking form, and tell your team in Slack.

    3. 03

      Share it anywhere

      Send the link, or add one line to Webflow, WordPress, Framer or any page. Every answer lands as a contact.

    • HubSpot
    • Salesforce
    • Omniscient
    • Pipedrive
    • Attio
    • Slack
    • Gmail
    • Outlook
    • Calendly
    • Zoom
    • Google Meet
    • Stripe
    • Zapier
    • Webflow
    • WordPress
    • Framer

    Frequently asked questions

    Something else? hello@tryclaritia.com

    Can I customize the case evaluation form?

    Yes. Add, remove and reorder questions, change the wording and options, and set which ones are required. Pick one of 18 styles or your own color. Tailor can also rewrite the wording for your business from one sentence.

    What does the case evaluation form collect?

    It asks for name, phone, email, city and state, type of case and next court date, plus 20 more questions. You can add or remove any of them.

    Is the case evaluation form mobile-friendly?

    Yes. Every form fits phones, tablets and computers, and works with a keyboard and screen readers.

    Is the case evaluation form template free?

    Yes. Every form template is free on every plan, including the free one. Use it, change it and share it as often as you like.

    Where do the answers go?

    Each answer is saved in Claritia with the page and campaign the visitor came from. From there it can sync to HubSpot, Salesforce or Omniscient.

    How do I put it on my website?

    Share the link, or paste one line of code where the form should show. It fits any website, including Webflow, WordPress, Framer and plain HTML.

    Does it ask for consent?

    Yes. Visitors in the EU, the UK and other strict regions see an opt-in box; everyone else sees a short notice. Claritia saves the exact words each person saw.

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