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Las Vegas Shooting Victim Questionnaire

Did you purchase tickets for the event?
Do you still have your tickets/wristband?
Which days did you attend the event?Check all that apply
Where were you located when the shooting began?
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What did you during the 10 minutes of shooting?
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Were you shot?
Were you physically injured?
Were you emotionally injured?
How did you get out of the venue?
Were you trapped inside the venue?
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Who were you with?
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Did you see anyone get shot?
Did you see any bodies on the ground that had been shot?
Did you render aid to any shooting victims?
How are you suffering now?
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Have you been placed on disability from the injuries?
Have you lost out on employment or earnings?
Have you been placed off work?
Nameyour full name
Phone Number
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