Free Consultation

FREE INITIAL CONSULTATION Call us at (480) 838-7000 or just fill in the form below and fax to (480) 838-1142 and we will call you.

The transmittal of this form does not create an attorney/client relationship unless agreed in writing.

Date of Accident


Location of Accident (Including City & State)


First Name   


Last Name

Email Address

                              
Address: (including city/State/Zip)


Home Phone                        

Work Phone

Mobile Phone

List Your Injury(s)

Any additional information you would like us to know:

 

Fax to (480) 838-1142

How did you hear about our office?

  • From someone Michael Trauscht helped in the past?
  • Other?

 


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