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Personal Injury, General Contact Form

The timely, cost-effective resolution of injury claims often calls for an attorney who is experienced in handling personal injury matters and dedicated to providing personal service. Contact our firm today to schedule a consultation and case evaluation with an experienced personal injury attorney.

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Personal Injury Contact Form

Name

Email Address

Phone Number

When were you injured?

How did the accident/injury happen?

Where did the event occur?

Was the accident/injury work-related?
Yes  No 

Were there any witnesses to the occurrence?
Yes  No 

Was an investigation conducted (police or otherwise)?
Yes  No 

Did you do anything to cause the accident?

Did you know any of the parties involved, prior to the accident?

When did you first receive medical care for your injury?

What was your diagnosis?

What treatment have you received?

How has your lifestyle changed as a result of the accident?

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Gregory S. Young Co., LPA
600 Vine Street, Suite 402
Cincinnati OH 45202
Toll Free 866-643-8793
Local 513-407-4218 | 859-547-3334
Fax: 513-721-1919
Cincinnati Main Law Office