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Online Case Assessment Form

Do I have a case?

Complete this free online case assessment form and a slip & fall lawyer from Yazdani Law Office will contact you within 12 hours to discuss your case. No obligations. Just answers.

    First Name:*

    Last Name:*

    Street Address:



    Home Phone:*

    Cell Phone:

    Email Address:*


    Case Details

    Date of the slip & fall (YYYY-MM-DD):

    Location of the slip & fall:

    Provide details about the slip and fall accident:

    Provide details about the injury that you suffered and any symptoms you are experiencing:

    I acknowledge and agree that no lawyer-client relationship is established by submitting this online case assessment form