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Sacramento Injury Case Evaluation Form
Please fill out the following Case Evaluation form and provide as much information as possible. All information is kept strictly confidential and is used only by Law Offices of John T. Stralen for the evaluation of your case. By accepting and reviewing this completed form, we are not agreeing to represent you. Rather, we will evaluate your information to determine whether or not we can accept your case.
Note: fields with a * are required.
YOUR CONTACT INFORMATION
*
First and Last Name:
*
Telephone:
*
Email Address:
YOUR INJURY INFORMATION
*
Date of Injury:
*
How were you injured:
*
Describe Your Injuries
Other Comments:
**PLEASE DO NOT GIVE A WRITTEN OR RECORDED STATEMENT TO THE INSURANCE COMPANY!**
Copyright 2008 The Law Offices of John T. Stralen, All Rights Reserved.
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