Consult Form | Lassiter Law

For a free, no-obligation consultation with an experienced attorney at the Lassiter Law Firm regarding your case, please submit the following response form. We will respect the confidentiality of your information to the fullest extent. Form submissions are relayed to us through our highly secure servers. Tell us who you are and how we can contact you.

Note: This information is strictly confidential and will not be communicated with anyone. It is necessary only for purposes of enabling us to do a conflict of interest check prior to responding to you. We cannot respond without being able to do our conflict check.

Your First Name

Your Last Name

Your Address *

Your City *

Your State *

Your Zip Code *

Email *

Day Phone

Night Phone

Is this free consult for yourself? *

Yes

No, someone else

Many times we are contacted by someone other than the person in need of help, such as a parent on behalf of a child, or wife on behalf of a husband. Please provide the following information on behalf of the person who needs assistance.

What is your relationship to the other person?

Behalf of First Name

Behalf of Last Name

Your Age

Their Age

Why do you need help? Please provide us with a very brief overview, in 200 words or less, describing in general the subject matter of your request. You can provide more detailed information below, but for now please confine yourself to providing us with a

State Injury Occurred

What injury occurred?

Where did the injury occur?

Who cause the injury? List all names and address/contact information

What were the damages or suffering due to the injury?

Has anyone filed a suit?

Yes

When is the best time to reach you by telephone?

Captcha

When the information you have provided is complete, please press the Submit button above to send it to our firm. Your information will be kept strictly confidential.For a free, no-obligation consultation with an experienced attorney at the Lassiter Law Firm regarding your case, please submit the following response form. We will respect the confidentiality of your information to the fullest extent. Form submissions are relayed to us through our highly secure servers. Tell us who you are and how we can contact you.