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Sacramento Personal Injury Case Consultation Form

Please fill out the following Case Consultation form and provide as much information as possible. All information is kept strictly confidential and is used only by The Law Offices of Adams & Corzine for the evaluation of your case. By accepting and reviewing this completed form, we are not agreeing to represent you. Rather, we will evaluate your information to determine whether or not we can accept your case.

Note: fields with a * are required.

CONTACT INFORMATION
* Your Name:
* Home Address:
* City:
* State:
* Zip Code:
* Home Telephone:
* Email Address:
INJURY INFORMATION
Type Injury:
Describe What Happened:
Date of Incident:
Any Other Comments: