Welcome to our office. We would appreciate you taking a few moments and fill out this form. This will help us serve you better.
THIS IS A FREE CONSULTATION. We do not represent you until you have signed a retainer agreement and Appointment of Representative.
In the event this law firm undertakes to represent you, all aspects of the representation including attorney fees and costs,
will be discussed and agreed upon. We want to make sure that you understand all procedures and aspects of
the case. We encourage you to ask questions. We also encourage you to divulge all information that you believe
is necessary to assist the attorney in formulating an opinion. Please remember that the attorney is only
rendering an opinion during this consultation. Anything he may say should not be construed as a guarantee
of the case.
Please take a moment and fill out this questionnaire as fully as possible. We understand that you may have good days and
bad days. When filling this out, think of a typical average day.
(If your disability is not physical, please proceed to Psychological portion)
Completing this worksheet will help you get ready for the interview.
We may ask for additional information at the interview. If you need more space, use blank sheets of paper.