# Verdict Form

1. Were the defendants at fault in one or more of the ways the plaintiff claims?

If "yes," go to question 2.

If "no," your verdict is for the defendants. Do not answer any more questions.

2. Was the plaintiff at fault in one or more of the ways the defendants claim?

If "yes," go to question 3.

If "no," go to question 4.

3. What is the percentage of each of the parties' fault?

(The percentages must total 100%)

If the plaintiff's percentage of fault is 50% or less, go to question 4.

If the plaintiff's percentage of fault is greater than 50%, your verdict is for the defendants. Do not answer any more questions.

Defendants' %

Plaintiff's %
4. What are the plaintiff's damages?

Do not reduce the damages by the plaintiff's percentage of fault, if any, because the court will do this when entering judgment.

Economic Damages

Past Medical Expenses $Future Medical Expenses$
Past Loss of Income $Future Impaired Earning Capacity$

Non-Economic Damages \$
Is this verdict unanimous?

Did all the participants come to an agreement on the answers?