www.ultimate-law.com
On Line resource for Personal Injury and Accident Claims
The symbol of British Justice
Personal Injury and Accident Claims Questionnaire
Please make sure you complete all fields
Name
Address
(area will suffice)
E-mail address
Accident Type
-- Select Type --
Road Traffic
At Work
Slip/Trip
Criminal Injuries
Uninsured/Untraced Driver
other
Where it happened
Date of Injury
Age at date of Accident
Have you seen a
solicitor about this
before - YES/NO
Brief Description of Injury
Brief Description of Accident
When we have received this information we will e-mail back to you as soon as possible. Thank you for selecting this firm to assist you
