Personal Injury Accident Attorney Case Form

Compensation amounts: {wereYou}
Who else was involved in the accident?*

Another driver (other car involved)No one else, I hit a deer/tree/swerved off the road

Compensation amounts: {haveYou}
When did this accident happen?*

Within 1 WeekWithin 1-3 monthsWithin 4-6 monthsWithin 1 YearLonger than 1 Year
The more recent your accident, the more likely you can achieve a higher settlement. If you've been in an accident, don't delay in getting help.

Compensation amounts: {typeA69}
Did you have to go to the doctor?*

YesNo
Medical visits can significantly impact your settlement value. Let us know if you sought treatment from your accident.

Compensation amounts:{typeA}
Are you currently represented by an attorney?*

YesYes, but I would like to changeNo
Having legal representation can change your options. Tell us if you already have a lawyer on your side.

Compensation amounts:{doYou}
Were you at fault?*

YesNo
You can be honest here. Determining fault is the best way to calculate settlement amounts. We need to know your perspective of the incident.

Describe your incident*

Contact information*

First Name Last Name

Please Enter Your Phone Number*
Please enter a valid phone number.

Please Enter Your Email*
Sasooness Law Group, PAC may contact you to follow up.

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