PIP Pain Injury — Florida Accident Injury Center & Hotline

Start Your Claim

Call our hotline or complete the intake form below. Eligible patients may qualify for a complimentary accident evaluation with a participating medical provider. Contact us to learn more.

CALL NOW — 407-486-6147 GET HELP NOW

Request an Accident Evaluation Start Your Claim

407-486-6147 — Florida Accident Injury Center & Hotline

Remember the 14-day rule — Florida PIP law requires you to seek medical treatment within 14 days of your accident to qualify for up to $10,000 in benefits. If you were recently in an accident, contact us promptly.

Request an Accident Evaluation

Complete the information below and a member of our team will follow up to connect you with a participating medical provider in your area.

Personal Information

Full Name *

Phone Number *

Email Address

Street Address

City

State

ZIP Code

Accident Information

Date of Accident

Type of Accident

Injury Information

What part of your body hurts the most?

Select all that apply.

Interactive Body Map — Mark Where It Hurts

Tap or click the body diagram to mark your pain areas. This is in addition to the selections above.

Tap / click to mark pain areas

Pain / InjuryHover to select

Selected injury areas (0):

No areas selected yet. Tap the body diagram to mark where you have pain or injury.

Browse all body areas

Please briefly describe where you are experiencing pain or discomfort.

Appointment Availability

What days work best for you to see a doctor?

Select all that apply.

Preferred appointment times

Transportation

Do you need help getting to your appointment?

Transportation coordination may be available. Subject to availability — not guaranteed.

I have my own transportationI may need transportation assistanceI definitely need transportation assistance

Insurance Claim Number (Optional)

You do not need a claim number to submit this form. Leave blank if you do not have one yet.

By submitting this form, you agree to be contacted by PIP Pain Injury. We are a medical referral and patient support service — not a law firm. This is not legal advice. By submitting this form you agree to our Privacy Policy and Terms of Use. View our Website Disclaimer.