Hello everyone. This is Robert Mansour and I want to welcome you to the forms page. Once you click on "Download the Forms," you're going to see the forms here. It's 10 pages that you can print out, but I want to walk you through it and help guide you here. So what's important to note is only sign the forms where you see an X. There's going to be other stuff there, but don't fill that stuff out. We will take care of that stuff. But wherever you see an X, please date, sign, etc. If you're not sure how to do something or you're confused about something, please call my office and we will walk you through it. The first thing is the actual contingency fee agreement. The contingency fee agreement means that the lawyer gets paid if I recover money for you from the accident.
So the first section here is a matter of covered services provided information about filing a lawsuit. If we decide to do that, associating other attorneys in your case, if that's necessary - No guarantees, litigation, costs and expenses. Important information about medical expenses that you might incur a little bit more about the actual contingency fee itself, the attorney's lien - withdrawal from the case by either party. If there's a dispute, there's an arbitration clause. Further agreements, file retention and client acknowledgement. So you just sign at the bottom.
Now if there's more than one client signing up, so for example, if there's two people, client number two would sign where indicated. We even have a space here for three people. If you're signing on behalf of a minor, make sure you sign as shown on the form. We have some guidance there for you. And at the very bottom of the retainer agreement, we ask that you put your best mailing address, your best phone number and email account you check regularly, not one that you check every few months and your birth date.
Next is the agency authorization form. This form allows my office to represent you and insurance companies and others will not talk to my office unless you fill this out. And again, just the bottom part where you see the X's. Now for each client, you're going to need a separate form for this one. Authorization to provide information - This one is used if you need our office to obtain the police report. If you didn't get your hands on it already, or if you're going to be making a claim for lost earnings, this might be helpful for you to fill out. And again, only where you see the X's on the bottom and we need one for each client. Next is something called the HIPAA compliant authorization form. And this is basically allowing my office access to your medical records from various medical providers.
Some places may have their own authorizations and we will deal with that when the time comes. But all you need do is fill out where you see X's on the second page. And if you're signing on behalf of a minor sign on the bottom and for each client we will need a separate form. Finally, and perhaps in my opinion, most importantly is the Client Responsibilities form. And I can't tell you how important this is. This is a whole bunch of tips and advice about how to handle your injury claim and how to best approach your injury claim so that you can maximize your chances of a successful outcome. Now, this is not going to guarantee a successful outcome, but if you do the things that are on these two pages, it's going to help a lot and it will make my life a lot easier as your attorney.
So I want you to pay very special attention to these responsibilities and these tips. Read it very carefully. If you have any questions about them, please let me know. If you want me to walk through it with you, I would be happy to. And then date, sign and print your name at the very bottom of the second page. Once again, I cannot emphasize how important these two pages are.
Once everything has been signed and returned to my office, we can then begin with your representation and we will walk you through all the other steps after that. Thank you very much for taking the time to watch this. I hope you found it helpful. Take care.
by Robert Mansour
Robert Mansour is a personal injury lawyer serving Santa Clarita, Valencia,