Prospective Clients | Cearley Law Firm

Frequently Asked Questions

Free Confidential Case Evaluation

* All indicated fields must be completed.
Type of Case:	Personal Injury or Death Product Liability or Drug Litigation Medical Malpractice
Identity of Individual Reporting Injury

* First Name:
* Last Name:
* Address:
* City:
* State:
Zip Code:
* E-mail Address:
* Daytime Phone:
Evening Phone:
Fax Number:

Information About Injured Person

The following information is about myself: Yes No
If "No", my relationalship to injured person is:

Identity of the Injured Person

Full Name:
Marital status:	Single Married
Date of Injury:	(MM/DD/YYYY)
City & State where injury occurred:
Please give a brief description of the injury, describing the nature of the injury and how you believe it came about:

Legal Information

Have you contacted other lawyers about your potential case? Yes No
If "Yes," did any lawyer agree to represent you? Yes No
Are you still being represented by that lawyer? Yes No

Insurance Information

Have you been contacted by an insurance adjuster or any representative for the party believed to be responsible for the injury? Yes No
Questions and Comments:




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This web page is a public source of general information. It is designed to be correct, complete and current, but this cannot be guaranteed. It is not intended to be a source of legal advice, so anyone reading or making a submission to this Web page should not rely on information it contains as legal advice. Settlements or verdicts regarding cases discussed herein were obtained due to the particulars of those cases, and we cannot and do not guarantee similar results and verdicts for other cases. While we accept and welcome email, submission of the Confidential Case Evaluation form to Cearley Law Firm does not create an attorney-client relationship. We will not accept requests for legal advice nor offer specific legal advice over the Internet.