Mass tort intake form template
This five-step mass tort intake form asks the case, the date of first use, legal representation and the claimant, then the contact details. You can clone this template into your Growform account and name your own cases.
What the form asks, step by step
The questions establish which litigation the inquiry belongs to and whether your firm is free to act. The form asks nothing about health or medical history.
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Step 1: “Which case are you contacting us about?”
The person types the name of the product or case in their own words.
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Step 2: “When did you first use the product or come into contact with it?”
The answer is a broad time band, which your team can confirm later.
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Step 3: “Do you already have a lawyer for this case?”
Someone who already has a lawyer needs a different reply from your intake team.
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Step 4: “Who are you contacting us for?”
Inquiries made for a relative are identified before the first call takes place.
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Step 5: “How shall we contact you about your case?”
Name, email and phone come last.
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After submitting
The confirmation says that a member of the intake team will make contact, and you can add your office hours.
Who it’s for
Law firms that handle mass tort litigation, and the marketing agencies that run campaigns for them, can use this template as the first screen of mass tort intake. Each submission names the case, gives a broad date of first use, states whether the person is already represented and says who the claim is for. The form records what the person reports. It does not assess the claim, and your attorneys decide whether a case can proceed. It works as a legal intake form for any campaign built around a single product or case.
For accident cases, the personal injury intake template is a closer fit.
Why this structure converts
- The opening question lets people name the case in their own words, which makes the form feel relevant immediately.
- The three questions that follow are single taps, so the form stays short on a phone.
- Representation is asked before contact details, so your team knows how to respond before anyone calls.
- Nothing about health is requested, so people can finish the form without sharing sensitive details online.
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Make it yours
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Turn the case into buttons
If your campaign covers one or two cases, replace the text field on step one with buttons that name them.
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Add consent to contact
Add a consent checkbox to the contact step so each person agrees to calls and messages before your team responds.
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Build one form per campaign
Copy the form for each case and mention the product in the heading, so every campaign has a matching landing page.
Frequently asked questions
What does a mass tort intake form ask?
This one asks which case the inquiry concerns, when the person first used the product, whether they already have a lawyer and who the claimant is. It finishes with a name, an email address and a phone number.
Does the form screen or qualify claims?
No. The form applies no scoring and no rules to the answers. It collects them, and your firm reviews each one and decides how to proceed.
Does it ask about medical history?
No. The template contains no health questions. Those details are better discussed directly with the firm.
Which legal software can receive the inquiries?
Growform can send each inquiry to Clio, Lawmatics, Filevine or a Google Sheet, as well as to your inbox.
What happens next?
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Step 1: Clone this form template
Clone this template into your Growform account (create one first if you don’t already have one). -
Step 2: Edit your form
Get creative and adjust your form's theme options, questions or layout in the Growform form builder. -
Step 3: Share or embed your form
Share a link to your form, or embed it in your existing website. Receive new submissions by email or send them to 7,000+ apps via Zapier.
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