New Client Claim Form
Please contact us using the form below. We have the expert medical doctors and lawyers available to review your case and get right back to you with expert advice and assistance.
Lawyers click here or call directly at (847) 673-4422.
Please note that you can pay in full immediately or charge a portion of the fee. The fee is $250.00 and is non-refundable.
PLEASE FILL IN ALL INFORMATION THAT YOU CAN. N.B. YOUR FORM WILL BE SUBMITTED EVEN IF FIELDS BLANK.