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

Law Office of Israel S Hernandez PLLC

501 N. Florence St., Ste.101

Casa Grande, AZ 85122

Phone: 866-621-2689

What was the date you were injured?

Please describe how you were injured?

What type of injuries do you have?

Select Auto or Motorcycle Accidents Bicycle Accidents Slip & Fall Dog Bite Wrongful Death Medical Negligence Nursing Home Neglect Rail Road Accident Hurt on the Job Other

Have you seen a doctor or medical provider regarding your injury?

Yes
No

Have you filed a police report?

Yes
No

Have you filed any insurance claims?

Yes
No

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

Yes
No

Does the other party involved have insurance that covers you for this type of accident?

Yes
No

Please explain your legal situation.

* Please enter the security code shown below:

      

By submitting an inquiry, you agree to our Terms & Conditions.

The information contained in this web site is intended to convey general information. It should not be construed as legal advice or opinion. It is not an offer to represent you, nor is it intended to create an attorney-client relationship.