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CASE INQUIRY FORM
If you have a potential case you would like
us to look into, please provide us the following information. ALL "*"
ENTRIES MUST BE COMPLETE TO SUBMIT A CASE TO US FOR REVIEW. As the Kuzmich Firm only practices in Texas, WE WILL ONLY CONSIDER CASES
OCCURRING INSIDE OF TEXAS, OR INVOLVING TEXANS OR TEXAS BASED ENTITIES.
After we have reviewed the information you supply, we will contact you to
either enter into a contract with you, put you in touch with another
attorney, or to inform you that we must decline your case for some reason.
SUBMISSION OF A CASE DOES CREATE A
CONTRACT OF EMPLOYMENT BETWEEN THE KUZMICH FIRM AND YOURSELF.
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| Your Name
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| Address
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| Daytime Phone Number
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| Your E-mail Address
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| Your Mailing Address
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| The date when this incident occurred. |
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| Pick the type of case which best describes your incident. |
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| A brief description of the facts of this incident |
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| A list of all injuries, damages, or harms caused in this incident. |
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| Has any other attorney
represented you for this incident? |
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Yes |
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Has a lawsuit be filed in a court on this incident
already? |
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Yes |
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No |
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No |
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| May we put you on our Mailing List for our Quarterly
Newsletter? |
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Yes |
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Any special instructions on contacting you. |
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No |
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