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By submitting the form below, your inquiry will be emailed directly to:

Evans Edwards, L.L.P.
4801 Woodway Dr., Suite 300-E
Houston, TX 77056
Phone: 866-641-9974

When did the accident occur?

What type of injuries do you have?

Auto/Motor Vehicle Accident
Slip and fall
Dog bite
Railroad accident
Wrongful death
Hurt on the job
Other

What is the extent of your injuries?

Was a police report made?

Yes
No

Were there any witnesses?

Yes
No

Do you have insurance that covers you for this type of incident?

Yes
No
Not Sure

Do other involved parties have insurance that covers this type of incident?

Yes
No
Not sure

Have you been contacted by any insurance representative?

Yes
No

How much are your medical bills to-date?


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