Meyer, Suozzi, English & Klein -- Personal Injury Law

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At Meyer, Suozzi, English & Klein, P.C. we open and read all contact requests on a daily basis.
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First Name:
Last Name:
Home Phone:	(ex. ###-###-####)
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Email Address:
Address:
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Please provide the best place, time, and method for contacting you.

Injured Person Information:

Date of Birth / Age:
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Were you injured?:

Yes

If not who are you inquiring on behalf of?

Case Description:

Please explain exactly what happened, trying to state as thoroughly as possible who you believe was responsible and why you believe that person was negligent:

Please explain the full extent of the victims injuries:

Comments / Additional Information
Is there anything else that would assist us in understanding the facts of your case?

I understand that the completion of this form does not constitute an attorney-client relationship and that relationship can only occur by the execution of a written agreement of retainer between the law firm and the client. This firm will take no action on your behalf without a written retainer agreement.

Yes