INJURY CLAIMS: GETTING STARTED

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If you were injured in a bike or car crash and have a question or would like a no obligation consultation, you can get started by
  • calling the office to set up an office or hospital visit; or
  • completing the following information request. A confidential response will follow no later than the next business day.

Please Note: Information provided will be held in confidence but filling out a this form does not establish an attorney/client relationship. No attorney/client relationship is created unless and until I receive a signed retainer agreement. If this matter is truly important to you, hire an attorney.


Contact Info

Name

The best way to reach me is by (Choose one or more)

Daytime phone number Evening phone number

E-mail

Current Street Address

City State Zip


Crash Details

Date of Injury / Incident: (xx/xx/xx)

Cause of Injury

The crash involved a

Make/Model of the other vehicle:

At the time, I was a Cyclist: Driver: Passenger: Pedestrian:

I was riding or driving a: (make/model)


Injury Details

Describe Injury

Were you treated in an emergency room? Yes: No:

Have you seen a doctor? Yes: No:

Diagnosis/Treatment:


Comments or Questions?


PLEASE NOTE: Under our Supreme Court's Rules of Professional Conduct, these pages might be considered a form of legal advertisement.

Just as important, please bear in mind that the information provided here is not specific legal advice, and you really shouldn't act on anything on this site without seeking professional counsel. While I hope that you do hire me to work for you, merely visiting this web site, or sending me an email should not (and will not) of itself create an attorney-client relationship between us. No one should hire a lawyer based on a visit to a web site or solely on some other form of advertisement. If and when you want to hire me as your lawyer, and if and when I agree to take on your case, we will sign a proper contract or I will give you some other type of written confirmation that we are attorney and client. Until then, please look around, enjoy yourself, and when you are ready, give me a call or drop me an e-mail .

email CONTACT ME AT::
221 North LaSalle Street, Suite 2040 , Chicago, IL 60601
Voice: 312.726.1512
Fax: 312.873.4043
Email: Mwass@wasserlaw.net

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This document maintained by mwass@wasserlaw.net
Material Copyright © 2000, 2001, 2002 Michael H. Wasserman