Submit A Free Case Review

Please submit the following information for a free case review. If you prefer, you may contact us at (608) 268-0268.

Please provide the following information for the person in need of assistance. Fields with (*) are required.

*Full Name

*Date of Birth

*Street Address

*City, State, Zip

E-Mail

*Home Phone

Other Phone

Please provide a brief overview of the legal matter you need assistance with.


Injury Cases

If you need assistance with an injury matter (including wrongful death claims, product liability claims and malpractice claims) please submit the following information as well.

City and State in which you were injured.

Please describe your injuries.

Are you still being treated for your injuries?
Yes
No

Have you been forced to miss work due to your injuries?
Yes
No

Have you been contacted by any insurance company regarding your injuries?
Yes
No


For Parents or Guardians

If the person in need of assistance is not a minor or disabled, we will need to communicate directly with that person regarding our review, in order to maintain attorney/client confidentiality. If the person in need of assistance is a minor or is a disabled adult with an appointed guardian, we will need to communicate with that parent or guardian. With this in mind:

*Who is the person to be contacted after we have completed our review?

*What is the best time to contact that person?

*What is the best way to contact that person? (e.g., e-mail, phone, letter)


After the information is complete, please press the submit button. We will review the information and contact you as soon as we have done a conflict of interest check.

An attorney client relationship is not established by submitting this initial contact information to our office.



Airplane AccidentsAuto AccidentsBoat AccidentsConstruction AccidentsDog BitesHazardous ProductsInsurance Bad FaithIntentional TortsMotor Vehicle AccidentsMotorcycle AccidentsNursing Home AbusePersonal InjuryPremises LiabilityProduct LiabilitySlip and FallSpinal Cord InjuryTraumatic Brain InjuryTruck AccidentsWorker's CompensationWrongful Death


©2006 Boller & Vaughan S.C. Wisconsin Personal Injury Attorneys - Madison Auto Accident Lawyers and Wrongful Death Law Firm. All rights reserved.
DisclaimerSitemap
 

Wisconsin Personal Injury Lawyers Disclaimer: The Wisconsin personal injury, wrongful death, negligence, automobile accident and/or other legal information offered herein by Boller & Vaughan S.C., Madison Personal Injury Lawyers, is not formal legal advice nor the formation of an attorney client relationship. Any results set forth herein are based only upon the facts of that particular case and offer no promise or guarantee on the outcome of any case. This site is not intended to solicit clients outside the State of Wisconsin.