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Accidents Involving a Slip, Trip or Fall

Anyone who is responsible for the running or maintaining of a public place (shops, offices, leisure attractions, public highways and pavements, etc) is obliged to make that place safe. If you injure yourself by slipping on a wet floor or tripping over a broken paving slab, for example, you may be entitled to claim compensation.

By filling in this form you can find out if you are entitled to compensation. Simply fill out each section and click on SUBMIT. Our online assessment system will analyse your details and tell you whether or not you have a claim. One of our advisors will then contact you (without obligation) to discuss the matter further within 24 hours (48 hours at weekends).

Your Details

Name:
Email address:
Home Tel No:
Mobile Tel No:
Best time to call:

Details of your accident

1.	What was the date of your accident? (DD/MM/YYYY)
2.	Do you have any photographs of the defect that caused you to slip or trip (or can you still get them)?	Yes / No
3.	Did the defect measure more than one inch?	Yes / No
4.	If you slipped or tripped on a pavement or road was it:
	(a) Busy Urban
	(b) Quiet Urban
	(c) Rural
5.	Did you report the accident to the council or anyone else?	Yes / No
6.	When did you go to your GP/Hospital?
	(a) Within 24 hours
	(b) Within 1 week
	(c) Not at all
7.	Did anyone else witness the accident?	Yes / No
8.	What was the time of the accident?
	(a) Before 7pm
	(b) After 7pm
9.	Had you been drinking?	Yes / No
10.	Were you running?	Yes / No