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Complete these questions and get a customized, timely response from prescreened and member referred Businesses that are interested in working with you. You choose the Business that best meets your needs. No Cost.
1) Did you hire your lawyer for personal or business reasons?  [required]
Business Reasons
Personal Reasons
2) On what date did you first hire your lawyer?  [required]
3) What was the original legal matter for which you had hired this lawyer?  [required]
4) What is the disposition of your original legal matter?  [required]
5) What type of negligence or breach of duty is alleged to have occurred?  [required]
6) How soon after hiring your lawyer did you first become aware there was an apparent problem?  [required]
7) Did you incur any injury, loss or damage as a result of the alleged negligence of your lawyer?  [required]
Yes
No
8) If yes, please provide brief description, including any estimated economic loss
9) Please indicate how you would prefer to to pay for the services of an attorney, should you hire one to help you with your legal matter. Note: there is no charge to sumbit your request.  [required]
Hourly Rate
Retainer
Flat Fee
Contingency
Not Sure
10) Comments or Details:

Service Location:  [required]
11)
ZIP Code:  -- OR --
City/State 

Contact Information:
12)
First Name: [required]
 Last Name: [required]
13)Email Address: [required]
14)
Day Time Phone: [required]
()-x		 Evening Phone:
()-
15)
Best Time: [required]

Terms of Service
16)I acknowledge that I have read and I agree to the TERMS AND CONDITIONS of this service [required]

Do not send confidential information via this service, as others may intercept it. No attorney-client relationship is created and the information is not privileged or confidential. Respond.com or any of its network or affiliate sites do not offer legal advice or receive any legal fees. This is not a Lawyer Referral Service. You are responsible for selecting an attorney. Attorneys are not obligated to take your matter merely because you sent it through the service or because they responded to your request
IF YOU NEED ASSISTANCE FILLING OUT THIS FORM,
PLEASE CALL 703-651-2060
(Monday - Friday 9am - 6pm EST)


 
 

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