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Premises Liability Case Intake Form

Premises Case Intake Form

  • Step1
  • Step2
  • Step 3
  • Step4
  • Step Final

Section1

I fell because I:

Section2

I fell:

I fell on:

The area was defective because:

Section3

I have photographs of the condition:

The incident was reported to police:

After the accident, I sought medical or hospital care:

Section4

I injured my:

The injuries have caused me to:

Additional Information:

I understand that the transmission of this information does not create an attorney client relationship but is, instead, a request for a free consultation with an attorney about the details of my potential case.

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