Do I have a case?

This form will assist us in identifying the particulars related to your issue. An attorney will be in touch with you regarding any follow up information we might need.

Name

Best Phone Number

City

State

Email

Who was injured?

If other, please specify name

If other, please specify relationship

Injured persons Street Address (if different from above)

City

State

Best Phone Number

Date of injury

Location of injury

Typ of accident

How did the injury happen?

Were there witnesses to the injury?
Yes No

If yes, what are their names and contact information?

Were others involved or injured at the same time?
Yes No

If yes, what are their names/contact information?

Was there a police report?
Yes No

Did the injured person receive medical treatment?
Yes No

Where did you hear about this website?

Once this information has been submitted, you may expect a prompt response from our Attorneys to discuss your case.


 

 

 

 

© 2006 All Rights Reserved, Bodkin & Mason, LLP., 37 Mechanic Street, Worcester, MA 01608