• Tell us about your claim

    Start with the basics. On the next page, you can tell us more about the case; answer what you can, and best guesses are fine.
  • Format: (000) 000-0000.
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  • This is where things start to get personal...

    Look, we get it. Divulging your personal business is not comfortable. We do not take it for granted. Know that everything you tell us is held in strict confidence and is protected by the attorney-client privilege, even though you are a client at this time, because your this form is for the purpose of obtaining legal advice. The more information you provide, the better we can assess your claims. So do your best to be as detailed as reasonably possible.

  • Identify Verification

    First thing's first: We need to confirm who you are.
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  • Marketing Stuff...

    We would very much appreciate if you could kindly tell us how you heard about Bearstone Law, PLLC, and why you chose us.

  • Claim Details for Attorney Review

    Strictly Confidential
  • Who got hurt or suffered the loss (i.e., who is the "Claimant")?*
  • When did it happen? (Earliest)*
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  • What is your relationship to the Claimant?
  • When did they pass away?
     - -
  • Was an autopsy performed?
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  • Did the decedent/Claimant pass away as a result of the conduct or activities described above in response to the question, "what happened?"
  • Who did the decedent/Claimant leave behind at the time of their death?
  • Has anyone been appointed as executor or administrator?
  • As far as you know, did decedent/Claimant have a written will?
  • What kind of case is this?*
  • Who do you think is responsible for the injury/harm/loss?*
  • Which of these exist today? (check all that apply)*
  • Where was the Claimant at the time of the accident/injury?
  • What best describes the accident?
  • What kind of vehicle was the other person driving (not you or the Claimant)?
  • Does the Claimant have their own auto insurance?
  • What do you think ultimately caused Claimant's injuries on the property?
  • Was a manager or the business owner/executive present when it happened?
  • Was a manager or the business owner/executive informed about the incident?
  • At what kind of property/location was the Claimant injured?
  • Does the employer carry workers' compensation insurance?
  • Was anyone besides the employer present at the location or involved in any way? (e.g., another company, a driver, an equipment manufacturer)
  • Was the injury reported to the employer?
  • Do you know who owns the animal?
  • As far as you know, had it bitten or attacked anyone before?
  • Do you still have the product?
  • What went wrong, medically speaking?
  • What happened to Claimant while in the care of the facility? (check all that apply)
  • Have Claimant's injuries/abuse been reported to the facility or to the state?
  • When did you first notice something was wrong?
     - -
  • What kind of insurance coverage is the claim seeking?
  • What has the insurance company done?
  • When did the Claimant first get medical care for their injuries?
  • Which of these apply to the relevant injuries? (check all that apply)
  • Roughly how much are the medical bills so far?
  • Has the injury kept the Claimant from working?
  • Roughly how much financially is at stake?
  • Does the person or company at fault have applicable insurance coverage?
  • Do you already have a lawyer?*
  • Have you done any of these with an insurance company?*
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  • Before you submit, please keep in mind . . .

    Submitting this form does NOT create an attorney-client relationship between you and Bearstone Law, PLLC. In submitting this form, you acknowledge and understand that you are merely inviting the Firm to review your case information and assess whether it might be able to help in your situation. If the firm concludes that your case might be a good fit with its practice, then someone will contact you directly to schedule an initial consultation. At the consultation, the attorney will explain that an attorney-client relationship, if any, is conditioned on both you and the Firm executing a written engagement agreement. And unfortunately, the Firm must be highly selective at what cases it takes on, and the vast majority of prospective clients will never become clients. Nonetheless, we are truly grateful that you have taken the time to complete this form. If we think your case is a good match for the Firm's practice, we will be in touch promptly to discuss next steps (i.e., typically no longer than a week, and often sooner).
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