Premises Case Intake Form 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.
Disclaimer