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Where did your accident happen?
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England
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What kind of accident was it?
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Select accident type
Accident at work
Accident in a public place
At my home or someone else’s
After medically negligent treatment
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When did it happen?
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Under 2.5 years ago
Over 2.5 years ago
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Last step! What are your details?
First Name
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Last Name
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What is your phone number?
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