Case Form

Use this email form to obtain a free consultation concerning the legal needs and issues which you have and we will determine whether we can assist you.

We should respond to you promptly. If you prefer to speak directly to someone in our office or have questions about this form, please call us toll free at 602.910.6144 or call us toll free at 1.888.349.3599.

To expedite your case evaluation, we encourage you to provide us with your name, phone number, and email address, so that one of our representative can contact you to get any additional information that may be needed.

NOTE: An asterisk (*) indicates REQUIRED information.

Use this email form to obtain a free consultation concerning your personal injury case and we will determine whether we can assist you.

Bold labels and This graphic indicates a required field. indicate required information.

Personal Information

If Workplace, did the injury occur as a result of employment activities?


If Other, was this a road accident?


If no, did the injury occur on another's property?


Were there witnesses to the injury?


Were others involved or injured at the same time?


Was there a police report?


Did the injured person receive medical treatment?


Was the injured person killed as a result of the accident?


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