Justin King - Initial Client Interview

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Initial Client Interview Form


Name: Justin King

Address: 123 Main Street, Kansas City, Missouri

Home Phone: (913)123-4567 Work Phone: (913)890-1234

Social Security Number: 123-45-6789

Driver’s License Number: MO39562243

Date of Birth: 7/14/83

Marital Status: Single Dependents: None

Military Status: N/A

Occupation: Student/Retail

Employer Name, Address, Phone Number:

Membership in Union or Professional Organization: N/A

Police Record (if any): N/A

Have you ever filed bankruptcy? If so, please explain. N/A


Type of Work: Retail Sales Job Title: Cashier

Immediate Supervisor’s Name: Jill Janes

Salary or Hourly Rate: $7.75/hour

Number of Hours Worked Weekly - Before Accident 20
- After Accident 0

Benefits (Company car, pension plan, vacation, expense account, etc.) N/A


Client, Justin King, claims he was a potential rising star (a singer) who had won the “National Idol Regional Contest” last year, on April 5th, in Chicago and that he was awarded a three year recording contract for $275,000 a yr plus a percentage of all sales with MCI Records. Mr. King further states that due to an accident on Interstate 57, just south of Chicago, he is now unable to fulfill his contractual duties because of injuries sustained to his jaw and face. Mr. King goes on to state that on or around the 8th of April he had left his agents house after signing his contract. He states that he was driving his motorcycle and was on his way home and he was “pretty freaking happy.” He said that he was driving in the left hand lane, going southbound on Interstate 57 when he noticed a beer truck going in the same direction (he’s unsure of the name-it’s either Coops, Coops Light or Coops Ultra), coming up behind him. He said at that point he noticed the truck had its flashers on indicating that the driver wanted to pass Mr. King so, Mr. King moved over to the right hand lane. After he moved over to let the truck pass, Mr. King states, “Next thing I know, I saw a couple of cases of beer coming at me, so I swerved left to get out of the way.” The next thing he remembers after that was being in the emergency room at the hospital in Paxton. Mr. King stated that he was in lot of pain because he had broken 9 facial bones and the Doctors had to wire his jaw shut. Mr. King also stated that he couldn’t eat for three days because they also put a tube down his throat. Mr. King went on to state the next day his agent called him and told him he had to withdraw from the National Idol Competition. Mr. King still wanted to compete in the contest so he stated, “Well I wanted to compete in the contest, dude, so I started to loosen the wires in my jaw so I could practice singing. Then this idiot doctor and nurse saw me and told me to keep the wires in there, so it would keep my “face together.” I started to get angry and then they gave me more drugs and I fell asleep and they handcuffed me to bed.” The next day, after waking and finding his family and agent in his room, he indicated on a piece of paper that he wanted to be moved to a “real” hospital. So his agent had him moved, by ambulance or AAA, to Metropolitan Memorial Hospital in Chicago where he was put into a private room. Mr. King is not sure but he thinks he may have signed some sort of release forms. He is also not clear if (he did) sign any forms if the Ambulance attendant gave them to the Doctor at Memorial. He is unable to remember clearly due to the heavy medication he was (and still is) on. He goes on to state that a couple of days later a Doctor came to check on him and told Mr. King that “his jaws were moving” That, “the wires were loose and that the left side of his face was higher than the right...
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