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Case Evaluation Form

Please complete and submit the form below. Your case will be evaluated and we will respond to you shortly. NOTE: An asterisk (*) indicates REQUIRED information. The use of the Internet or this form for communication with our firm or any individual member of our firm does not establish an attorney-client relationship.

Name*

Address

Phone*

Email*

How did you hear about the firm?

Who is the Case Against?

Please give us a description of your case.*

Do you have an attorney?

Yes

No

Date of Incident

Has a lawsuit been filed?

Yes

No

If yes where and when??

What Type of Case is This?