After You've Been Injured from David Swanson Use the online form below to tell us about your accident. What Happened? In your own words, describe your issue.*When Did it Happen? MM slash DD slash YYYY Where Did it Happen? City State / Province / Region Provide Any Information on Adjuster/Injury ClaimInsurance Company, Adjuster Name, Adjuster Telephone Number.Your Name* First Last Your Email* Enter Email Confirm Email Your Phone*Upload Documents Drop files here or Select files Max. file size: 4 MB, Max. files: 10. Provide copy of accident report, exchange slip, bills, photos, etc.