Previous Injuries Have you ever been in another car accident, even just a fender bender?Have you ever been in an accident that was your fault?Have you ever been struck from behind by another vehicle?Have you ever struck another vehicle from behind?Have you ever t-boned somebody else or been t-boned?Have you ever had to make an insurance claim for damage to your vehicle?What about when somebody else was driving? Have you ever been in an accident when somebody else was driving? Even if it was just a fender bender?Ever been in a vehicle accident where there was no damage to the vehicles?What about when you were a child? Where you ever in an accident as a child, even if you weren’t hurt?Have you ever had a slip and fall accident?Have you ever slipped and fell at home? Not even a scraped knee?Have you ever tripped on anything and hurt yourself?Have you ever twisted your ankle?Have you ever sprained your knee, wrist, neck, back?Ever been injured on the job? Not even a paper cut?Ever been injured in a fight? Ever been injured playing sports? Football? Basketball? Running? Biking?Ever suffered a concussion?Ever fell out of a tree?Ever had a motorcycle, jet ski, go-cart injury?Have you ever twisted your back? When and where did you treat?Have you ever been in any other automobile accidents? When and where? Did you receive any treatment?Have you ever injured either of your arms? When and where did you treat?Have you ever injured either of your legs? When and where did you treat?Have you ever suffered headaches? When and where did you treat?Have you ever suffered dizziness? When and where did you treat?Have you ever suffered numbness or tingling in your arms or legs? When and where did you treat? This iframe contains the logic required to handle Ajax powered Gravity Forms.
