Car Accident Case Intake Form

Attorney Joseph G. Macaluso, founder of www.lawyers24-7.com, is a partner at Macaluso & Fafinski, P.C. a New York personal injury law firm fighting for our clients to get the best results possible with lawyers handling accident, injury, medical malpractice and dental malpractice claims in Bronx, Brooklyn, Queens, Manhattan, Staten Island and other areas in New York. Call now for a free consultation or simply fill out a Case Intake Form -- and let one of our attorneys tell you if you have a case.

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Car Accident Intake Form

Section1

The date of the accident was:

The location of the accident was:

I was a:

Please Explain

Section2

The accident happened at a:

Please Explain

Section3

The incident was reported to police:

After the accident, I sought medical or hospital care:

Section4

I injured my:

Please Explain

The injuries have caused me to:

Please Explain

Additional Information:

Name

My email address is:

My telephone number is:

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Submit Some Information - Find out if you have a Case

Want Us to Call you ?

Want to Leader more About the law First ?

Case Intake Forms

Pick Your Case Type - Answer a Few Questions - Find Out If You Have a Case

Car Accident Intake Form

Section1

The date of the accident was:

The location of the accident was:

I was a:

Please Explain

Section2

The accident happened at a:

Please Explain

Section3

The incident was reported to police:

After the accident, I sought medical or hospital care:

Section4

I injured my:

Please Explain

The injuries have caused me to:

Please Explain

Additional Information:

Name

My email address is:

My telephone number is:

Disclaimer