314 Ninth Street, Suite 100

Huntington, WV 25701

T: (304) 948-8529

F: (304) 948-8282

Post Office Box 585

Huntington, WV 25710

T: (304) 948-8529

F: (304) 948-8282

Complete this form as completely and accurately as you can. Proper information helps us to determine how we can best help you. Please know that submitting information through this form does not create an attorney-client relationship and that we will only represent you after we've both agreed to representation.

Contact information

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Case Information

This is where you can provide us with general details about your case. Please do not share confidential information here.

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Date of Incident

Is there already a case filed?

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When was the case filed? Where you served? When were you served?

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Have you contacted any other attorneys about this case?

Yes

Who? When? Did they decline to represent you?

Have you signed anything with any other attorneys or law firms regarding this case?

Yes

How Were You Referred to Us?

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How were you referred to us?

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