Online Consultation Request

Tampa, Florida Personal Injury Attorney: (813) 915-1110

Home

About Us

Resources

Free Consultation

» Evaluating Lawyers

» Affording an Attorney

» Lawyer Bios

» Client Testimonials

» Free Consultation

"Your unwavering commitment to my family, and the love and compassion you have shown by your actions, and not just words, have had a dramatic, unforgettable impact on us all."


	Online Consultation Request

Please complete the following questionnaire if you believe that you or someone close to you may have a personal injury or wrongful death claim. By completing the questionnaire, you will enable us to provide you with a detailed evaluation of your case. There is no cost to you for this case evaluation.

You should expect that attorneys Michael Hancock or Claire Hancock will review your completed questionnaire, evaluate your claim, and respond to you, either by e-mail or telephone, within 24 hours.

1. My Contact Information

Prefix:

Mr.

Mrs.

Ms.

Dr.

First Name:

Last Name:

Address:

City:

County:

State:

ZIP Code:

Home Phone Number:

Daytime Phone Number:

E-mail Address:

Preferred Contact Method:

by Phone

by E-mail

2. My Case Involves

	Automobile Accident		Medical Malpractice
	Motorcycle Accident		Nursing Home Abuse/Neglect
	Slip and Fall		Defective Product
	Dog Bite		Insurance Dispute
	Sinkhole Damage		Wrongful Death
	Other

3. My Questions

Description of the accident/incident/malpractice, including the date and location:

Description of your injuries and any medical treatment:

Feel free to ask any qeneral comments or questions you may have:

Hancock & Hancock, Tampa, Florida Personal Injury Attorney
2805 W. Busch Boulevard, Suite 201, Tampa, Florida 33618
PHONE: (813) 915-1110 FAX: (813) 915-1115 E-MAIL: hancock@lawhancock.com