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Request for Case Evaluation
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Last Name
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How did you hear about our office?
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Website (www.disabilityadvocacygroup.com
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Please tell us more about how you heard about our office (you answered "other" above).
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Please tell us about your issue. What kind of help are you looking for?
For assistance with disability claims: please provide details regarding work status, diagnosed conditions, and medical treatment.
Do you currently have an attorney representing you?
No
Yes for this matter.
Yes for another matter.
Previously for this matter.
Please attach any recent decisions or records that will help us review your matter.
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