Washington Bike Law Case Evaluation Intake

Confidential Case Review Form

For a free case review, please complete the form below. Washington Bike Law will promptly review the information you provide and should be in contact with you by the next workday.

If you have not heard from us within this timeframe or if have questions or concerns that cannot wait, please call us at 206.262.9290 or email info@washingtonbikelaw.com

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Provide Your Contact Details:

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Date of Incident (day, month, and year)*:

Briefly describe the Incident*

Briefly describe your injuries and treatment (if any) from the Incident*

Location of Incident (city, state, and approximate address or description of area)*

Name of Person or Entity you believe should be found responsible for the incident (if known)

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Who referred you to Washington Bike Law, and/or how did you learn about Washington Bike Law?

Were you referred to a specific attorney at Washington Bike Law?

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Prefered Contact Method*:

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Agree with Terms & Conditions

Step 5 of 5: Review & Submit

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If the summary below is correct, please "solve the math" to show you are a real person.

If you need to make changes, use the back button.

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All of the information you provided will be kept confidential and it will be considered a confidential attorney-client communication even if you do not retain Washington Bike Law.

Agree with Terms & Conditions:

Confidential Case Review Form

Step 1 of 5

Provide Your Contact Details:

Step 2 of 5

Date of Incident (day, month, and year)*:

Briefly describe the Incident*

Briefly describe your injuries and treatment (if any) from the Incident*

Location of Incident (city, state, and approximate address or description of area)*

Name of Person or Entity you believe should be found responsible for the incident (if known)

Step 3 of 5

Who referred you to Washington Bike Law, and/or how did you learn about Washington Bike Law?

Were you referred to a specific attorney at Washington Bike Law?

Other Comments or Questions (optional)

Step 4 of 5

Prefered Contact Method*:

Step 5 of 5: Review & Submit

If the summary below is correct, please "solve the math" to show you are a real person. If you need to make changes, use the back button.

Section One

Section Two

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Section Four

If the summary below is correct, please "solve the math" to show you are a real person.

If you need to make changes, use the back button.