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ASSESSMENT Q/A FORM

INVOLVED IN A PERSONAL INJURY? NO WIN – NO FEE

You maybe entitled to paid medical treatment & maximum compensation

 

GET THE HELP YOU NEED BY COMPLETING THE QUESTIONNAIRE

    How were you hurt? Please complete all the question for best results

    Car AccidentMotorcycle AccidentBus AccidentBicycle AccidentTruck AccidentUber/Lyft AccidentPedestrian AccidentWrongful DeathOther Injury or Accident

    Briefly describe your accident

    Did you have to go to the doctor?

    YesNo

    What is your phone number?

    ### - ### - ####

    What is your Full name?

    First Name

    Last Name


    Email

    When did the accident or injury occur?

    In the last 30 days2023 (outside 30 days)2022202120202020 or Before

    We’ll call you within 24 hours to see if you qualify

    You will receive a call or an email from our office to discuss your case
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    Involved in a personal injury?

    Complete the Q & A Form below. You maybe entitled to paid medical treatment & maximum compensation.

    Recover what you deserve
    fast & easy  NO WIN – NO FEE

    Over $ 815.000

    Car v. truck accident

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    In Los Angeles last 20 years

    Reliable & exceptional

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    This site displays some of the representative cases Joshua Haffner handled at Haffner Law PC or his prior law firms – Copyright © 2023 Haffner Law