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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