Motor-vehicle accident — lead intake

Submits directly to the buyer's call-enrichment API
48-hour bridge window · caller ID must match on the live call
Before you submit: every field has a short note under it explaining exactly what to enter and in what format — read it before typing if you're not sure. Fields marked * are required. Anything left blank is simply left out of the submission, so only fill in what you actually know — don't guess to fill a gap. If a submission is rejected, the exact problem is shown under each affected field, not just as a generic error at the top.
Caller & contact
The number the bridge will dial from — must match the live call exactly. Any format works here; it is auto-converted to +1XXXXXXXXXX before sending.
e.g. Jane. Leave blank if you only have the full name below.
e.g. Doe.
e.g. Jane Doe. The buyer auto-splits this into first/last, so use First Name + Last Name above instead if you already have them separately.
A real, deliverable address, e.g. jane@example.com.
Use the date picker — it always saves as YYYY-MM-DD.
5 digits, e.g. 90001 (ZIP+4 like 90001-1234 is also fine).
Same format as ZIP code above — only needed if your workflow specifically calls for this field name.
The caller's state. Drives which call target is eligible to receive this lead — pick from the list, don't type it.
e.g. English or Spanish.
Case identifiers & routing
3ca6367b-4444-443e-9284-d1153ccf204afixed
Fixed for this form — always sent as 3ca6367b-4444-443e-9284-d1153ccf204a, regardless of anything else on the page.
8fabd126-d051-491b-9858-a6585e25822cfixed
Fixed for this form — always sent as 8fabd126-d051-491b-9858-a6585e25822c, regardless of anything else on the page.
Any ID you use internally, e.g. LD-10432. Shown on the call record so you can reconcile it later.
An ID from a third-party system this lead came from, if any.
An ID from whichever partner platform originated this submission, if applicable.
Identifies which traffic source generated this lead, per your own tracking setup.
A sub-tracking value under Source ID, if you use one.
Where the caller came from, e.g. Google Ads, Facebook, organic.
A readable name for you as the supplier — separate from the Supplier ID UUID above.
Only set this if the buyer told you which SKU code applies to this lead.
Which product this call is being sold as. Pick ems_verified_live_transfer only if EMS transport was actually confirmed.
The raw URL querystring the caller landed on, if you track it, e.g. utm_source=google&utm_campaign=mva.
When the call happened, e.g. 2026-09-21T14:32:00Z. Free text — no strict format enforced.
Only needed if it differs from Caller phone (E.164) above — e.g. the number exactly as your dialer captured it.
A direct, publicly reachable link to the recording, e.g. https://recordings.example.com/call123.mp3.
Accident details
Date of the motor vehicle accident. Use the date picker.
Only needed if your integration expects this exact field name instead of Incident date.
Another alternate name for the same date — fill in one of the three, not all three.
How long ago the accident happened. Send the narrowest bucket that applies — this is what target call filters actually key off, separate from the raw date fields above.
e.g. rear-end collision, T-bone, rollover, sideswipe.
City where the accident occurred, e.g. Sacramento.
Pick from the list — only needed if it differs from the caller's state above.
The caller's role in the accident.
Whether the caller themself was at fault.
A more detailed alternate to "Claimant at fault" above.
Whether the caller carries their own uninsured/underinsured-motorist coverage.
Whether a copy of the report can actually be produced, as opposed to whether one was filed.
e.g. a delivery van, semi-truck or rideshare vehicle was involved.
A short free-text summary of how the accident happened.
Broader case notes — injuries, treatment, representation status, anything relevant to qualifying the lead.
Injury & treatment
A stricter confirmation than "Caller was injured" — set once an actual physical injury is verified.
e.g. whiplash, back injury, broken bone.
A short free-text description of the injury in the caller's own words.
e.g. ongoing physical therapy, discharged, awaiting surgery.
Whether the caller has received any treatment at all.
Whether treatment is ongoing right now.
Whole number of days between the accident and first treatment, e.g. 3. A large gap can hurt the case, so buyers often filter on this.
Whether an ambulance actually transported the caller from the accident scene.
Only set "Yes" once EMS verification has actually passed — this drives the EMS-verified target filter, so don't guess.
Outcome
How this call was classified after screening. This is usually set by whoever qualified the call, not guessed up front.
Test mode
Leave this off to store real data and start the 48-hour bridge window.
Fields marked * are required by the buyer's API.