Do I Have a Case?

Do I Have a Case?
This form is provided for you to help me in evaluating your claim. Please submit it with as many details as possible. If you experience any difficulty with this form, please contact me at krodgers@lawrodgers.com or by phone at 215-923-3330.

Your name:
Street Address:
City:
State:
Zip:
Phone Number :
Email Address :
Date of injury:
Nature of your injury:
Where did the injury occur?
Parties you believe to be responsible, and why: * 500 character limit
What action other lawyers have taken about your potential claim:
Medical care to date:
Time missed from work as the result of injury:

Office of Kenneth M. Rodgers, PC
1515 Market Street, Suite 1201
Philadelphia, PA 19102
phone 215-923-3330
fax 215-751-1691
email krodgers@lawrodgers.com