Facebook Pixel


Personal Injury Questionnaire

start your free consultation
Home Personal Injury Questionnaire

Personal Injury Questionnaire

Earn 10,000 American Airlines Frequent Flyer miles while we handle your case — 2,000 when retainer signed, 8,000 at conclusion of your case!

For a free evaluation of your personal injury claim, please fill out the following form completely and submit it to us. We try to respond to all submissions by telephone, usually the following day. Please be aware that in submitting this form you are not retaining legal services from the Law Offices of Edward A. Smith.

The items listed in this form are the minimum facts needed for an attorney to begin to evaluate your claim, so even if you do not retain our services for your claim it will still be helpful for you to collect this basic information before contacting any other attorney.

And if you do decide to retain our services, we can get a jumpstart on formulating a plan of attack, putting together a powerful case so that by the time you meet with us, we are already well ahead of the game.