Case Submission Form

Submitting a claim does not create an attorney/client relationship. Do not assume that we will take any steps to preserve a claim that you might have just because you have contacted us on this website or by telephone. We only provide legal services after a power of attorney has been signed by you and accepted by us in writing. Please see our legal page for further information.

Name
Email
Phone
 
Date of Injury
Breif Description of Injury
 

 

 

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