SACRAMENTO INJURY ACCIDENT ATTORNEY CONSULTATION

Please fill out the following Case Evaluation form and provide as much information as possible. All information is kept strictly confidential and is used only by Richard Allaye Chan, Jr., A Professional Corporation for the evaluation of your case. By accepting and reviewing this completed form it is not creating an attorney client relationship. Rather the information is accepted by the firm in order to make a determination whether or not we can accept your case.

Please read before submitting: If you are currently represented by an attorney please do not submit this form.

CONTACT INFORMATION
* Your Name:
* Home Address:
* City:
* State:
* Zip Code:
* Best Telephone:
* Email Address:
INJURY INFORMATION
Injury type:
Where did injury occur?
Date & Time of injury:
How did the injury accur?
Who was at fault & why?
Comments:
Image Varification:

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(916) 446-4400

Toll Free: (888) 446-4333

Richard Allaye Chan, Jr.
A Professional Corporation
1000 G Street, Suite 220
Sacramento, CA 95814

Toll Free:
1-888-446-4333

SACRAMENTO: (916) 446-4400
PLACER: (916) 783-9696
YOLO: (530) 666-6464
EL DORADO: (916) 446-4400
STOCKTON: (209) 952-9500
SOLANO: (707) 429-4242
YUBA CITY: (530) 673-1400
TRUCKEE: (530) 587-3400
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