First Name
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Last Name
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Pronouns (example: she/her)
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Title (example: Ms., Mr., Mrs., Dr., etc.)
Email Address
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Phone
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How did you learn about SGB? (Please be specific and give the name of the attorney or law firm, if relevant.)
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Were you referred to one of our attorneys and if so, whom?
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Tell us briefly about your situation, and what happened that has led you to want to sue.
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Whom do you wish to sue? (Please provide the name of the individual or organization, so we can perform a conflict check.)
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What injury or damage did they cause you? Please be specific about what the harm was (for example, instead of simply saying “personal injury,” tell us “they broke my leg, and it has not healed.”).
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Approximately what date(s) did this occur?
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In what US state did this occur?
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In what US state did this occur? *
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Are you filling this form out on behalf of someone else, and if so, whom?
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Is there anything else you would like to tell us about your situation?
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