<% Sub DisplayForm %>
Wards are a firm of regional South West solicitors, with offices specialising in personal injury claims. All cases are handled by solicitors who are Law Society Personal Injury Panellists and approved by them, due to our experience, the volumes of similar cases we handle and our quality control procedures.
Wards offer a free initial interview of 30 minutes on all accident/injury claims. This can be in person if you are local to one of our offices, or by telephone.
Please ensure you complete all fields
<% End Sub Sub DisplayResults %> Your details have been submittedThank you for completing our Accident Assessment Form. Your details are listed below as a reminder (you can copy and paste them into a document and save them or print the page as a record).
A solicitor will contact you within one working day to discuss the possible next step you can take. In the meantime, if you have any queries, please contact Janet Rimmer on 01275 858 515.
Accident Details
- Accident Type : <%=strAccidentType%>
- Accident Type if Other : <%=strOther%>
- Description : <%=strDescription%>
- Accident Date : <%=strDay & "/" & strMonth & "/" & strYear%>
- Location : <%=strLocation%>
- Responsible : <%=strResponsible%>
- Instructed : <%=strInstructed%>
- Title : <%=strTitle%>
- Forename : <%=strForename%>
- Surname : <%=strSurname%>
- Address : <%=strAddress%>
- Town : <%=strTown%>
- County : <%=strCounty%>
- Postcode : <%=strPostcode%>
- Telephone : <%=strTelephone%>
- e-mail : <%=strEMail%>
- DOB : <%=strDOB%>
- Branch : <%=strBranch%>
- Marketing : <%=strMarketing%>
Wards homepage
<%
End Sub
Sub ValidateForm
If strAccidentType <> "" Then
bPartial = True
Else
bComplete = False
End If
If strDescription <> "" Then
bPartial = True
Else
bComplete = False
End If
If strDay <> "Day" AND strDay <> "" Then
bPartial = True
Else
bComplete = False
bDate = False
End If
If strMonth <> "Month" AND strMonth <> "" Then
bPartial = True
Else
bComplete = False
bDate = False
End If
If strYear <> "Year" AND strYear <> "" Then
bPartial = True
Else
bComplete = False
bDate = False
End If
If bDate Then
dtAccident = DateSerial(Cint(strYear), Cint(strMonth), Cint(strDay))
End If
If strLocation <> "" Then
bPartial = True
Else
bComplete = False
End If
If strResponsible <> "" Then
bPartial = True
Else
bComplete = False
End If
If strInstructed <> "" Then
bPartial = True
Else
bComplete = False
End If
If strTitle <> "Title" AND strTitle <> "" Then
bPartial = True
Else
bComplete = False
End If
If strForename <> "" Then
bPartial = True
Else
bComplete = False
End If
If strSurname <> "" Then
bPartial = True
Else
bComplete = False
End If
If strAddress <> "" Then
bPartial = True
Else
bComplete = False
End If
If strTown <> "" Then
bPartial = True
Else
bComplete = False
End If
If strCounty <> "" Then
bPartial = True
Else
bComplete = False
End If
If strPostcode <> "" Then
bPartial = True
Else
bComplete = False
End If
If strTelephone <> "" Then
bPartial = True
Else
bComplete = False
End If
If strEMail <> "" Then
bPartial = True
Else
bComplete = False
End If
If strDOB <> "" Then
bPartial = True
Else
bComplete = False
End If
End Sub
Sub ListErrors
If strAccidentType = "" Then
Response.Write("Please select an accident type.
")
End If
If strAccidentType = "Other" AND strOther = "" Then
Response.Write("Please enter an accident type.
")
End If
If strDescription = "" Then
Response.Write("Please enter an accident description.
")
End If
If bDate Then
If DatePart("d", dtAccident) <> Cint(strDay) OR DatePart("m", dtAccident) <> Cint(strMonth) Then
Response.Write("Please enter a valid date.
")
End If
Else
Response.Write("Please enter a valid date.
")
End If
If strLocation = "" Then
Response.Write("Please enter an accident location.
")
End If
If strResponsible = "" Then
Response.Write("Please say who you think was responsible.
")
End If
If strInstructed = "" Then
Response.Write("Please say whether you have previously instruced a solicitor.
")
End If
If strTitle = "" OR strTitle = "Title" Then
Response.Write("Please select a title.
")
End If
If strForename = "" Then
Response.Write("Please enter your forename.
")
End If
If strSurname = "" Then
Response.Write("Please enter your surname.
")
End If
If strAddress = "" Then
Response.Write("Please enter your address.
")
End If
If strTown = "" Then
Response.Write("Please enter your town.
")
End If
If strCounty = "" Then
Response.Write("Please enter your county.
")
End If
If strPostcode = "" Then
Response.Write("Please enter your postcode.
")
End If
If strTelephone = "" Then
Response.Write("Please enter your telephone number.
")
End If
If strDOB = "" Then
Response.Write("Please enter your Date of Birth.
")
End If
If strEMail = "" Then
Response.Write("Please enter your e-mail address.
")
End If
End Sub
'Sub MailDetails
' Dim strBody, strEOL, Mailer
' strEOL = Chr(13) & Chr(10)
' Set Mailer = Server.CreateObject("CDONTS.NewMail")
' Mailer.From = "Accident@wards.uk.com"
' Mailer.To = "Alison.Underhill@wards.uk.com;Helen.Gough@wards.uk.com;Janet.Rimmer@wards.uk.com;Larry.Rawlinson@wards.uk.com"
' Mailer.Subject = "Accident Details"
' strBody = strBody & "Accident Type : " & strAccidentType & strEOL
' strBody = strBody & "Accident Type if Other : " & strOther & strEOL
' strBody = strBody & "Description : " & strDescription & strEOL
' strBody = strBody & "Accident Date : " & strDay & "/" & strMonth & "/" & strYear & strEOL
' strBody = strBody & "Location : " & strLocation & strEOL
' strBody = strBody & "Responsible : " & strResponsible & strEOL
' strBody = strBody & "Instructed : " & strInstructed & strEOL
' strBody = strBody & "Title : " & strTitle & strEOL
' strBody = strBody & "Forename : " & strForename & strEOL
' strBody = strBody & "Surname : " & strSurname & strEOL
' strBody = strBody & "Address : " & strAddress & strEOL
' strBody = strBody & "Town : " & strTown & strEOL
' strBody = strBody & "County : " & strCounty & strEOL
' strBody = strBody & "Postcode : " & strPostcode & strEOL
' strBody = strBody & "Telephone : " & strTelephone & strEOL
' strBody = strBody & "e-mail : " & strEMail & strEOL
' strBody = strBody & "DOB : " & strDOB & strEOL
' strBody = strBody & "Branch : " & strBranch & strEOL
' strBody = strBody & "Marketing : " & strMarketing & strEOL
' Mailer.Body = strBody
' Mailer.Send
' Set Mailer = nothing
'End Sub
%>
<%
Dim strAccidentType, strOther, strDescription, strDay, strMonth, strYear, strLocation, strResponsible, strInstructed, strTitle
Dim strForename, strSurname, strAddress, strTown, strCounty, strPostcode, strTelephone, strEMail, strBranch, strDOB, strMarketing
Dim bPartial, bComplete, bDate, dtAccident
strDay = "0"
strMonth = "0"
strYear = "0"
strAccidentType=Request("AccidentType")
strOther=Request("Other")
strDescription=Request("Description")
strDay=Request("Day")
strMonth=Request("Month")
strYear=Request("Year")
strLocation=Request("Location")
strResponsible=Request("Responsible")
strInstructed=Request("Instructed")
strTitle=Request("Title")
strForename=Request("Forename")
strSurname=Request("Surname")
strAddress=Request("Address")
strTown=Request("Town")
strCounty=Request("County")
strPostcode=UCase(Request("Postcode"))
strTelephone=Request("Telephone")
strEMail=Request("EMail")
strDOB=Request("DOB")
strBranch=Request("Branch")
strMarketing=Request("Marketing")
bPartial = False
bComplete = True
bDate = True
ValidateForm
If bComplete Then
' MailDetails
DisplayResults
Else
DisplayForm
End If
%>
<% Response.write GetHTMLSnippet("site-footer-asp-forms") %>