New York Firefighter Lawyers - Barasch McGarry Salzman & Penson

FREE CASE EVALUATION

Complete the Case Evaluation Form below and either...

E-mail it to us at michael@personalinjuryjustice.com or michael@firelaw.com, or
Snail mail us at: 11 Park Place, New York, NY 10007, or
Fax us at: (212) 385-7845

Of course, during normal business hours, we can be reached at (800) 562-9190.

First, briefly describe the type of accident, your injuries, and how your injuries occurred:

Now, tell us about you...
(All Fields MUST be completed in full.)

First Name:

Last Name:

Address:

City:

State:

Zip Code:

Contact Phone Number:
(where we can contact you)

E-mail Address:

Date: