Kevin A. Adamson, PC - Trial LawyersAtlanta, Georgia
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Case Evaluation Form

*Name:
*Address:
*City:
*State:
*Zip:
*E-mail address:
*Home Phone:
Business Phone:
Cellular or Pager:
Facsimile:
Who was injured?
If "Other ", please describe:
Injured person's name (if different from above):
Address:
City:
State:
Zip:
E-mail address:
Home Phone:
Business Phone:
Cellular or Pager:
Facsimile:
When did the injury occur?
Where did the injury occur?
Was this location the injured person's
If "Workplace," did the injury occur as a result of employment activities?
YesNo
If "Other," was this a road accident?
YesNo
If no, did the injury occur on another's property?
YesNo
If yes, who owns the property?
How did the injury happen?
What were the surrounding circumstances (weather, lighting, slipperiness, other)?
Were there witnesses to the injury?
YesNo
If yes, what are their names/contact information?
Were others involved or injured at the same time?
YesNo

If yes, what are their names/contact information?

Was there a police report?
YesNo
Did the injured person receive medical treatment?
YesNo
If yes, provide dates, locations, provider names, and details:
Is the injured person still receiving treatment?
YesNo
Was the injured person killed as a result of the accident?
YesNo
If yes, what was the date of his or her death?
Describe lifestyle changes experienced by the injured person and his or her family as a result of the accident:
Describe other losses resulting from the injury (lost wages, damaged property, other):
Where did you hear about this website?
 

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Kevin A. Adamson, PC
101 Marietta Street NW, Suite 3305
Atlanta, GA 30303-2720
Phone: (404) 581-9100
Toll Free: 1-866-581-9911
Fax: (404) 581-9111

Kevin A. Adamson, P.C. serves clients throughout the metro Atlanta area as far north as Blairsville, and as far south as Thomasville.  We have and will continue to take cases in other states throughout the Southeast and the United States.

Marietta  Lawrenceville  Decatur  Smyrna  Tucker  Kennesaw  Cherokee County  Cobb County  Fulton County  De Kalb County  Gwinnett County  Clayton County  Douglas County  Paulding County ○ South Carolina   Florida   Alabama


The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for individual advice regarding your own situation. Kevin A. Adamson is responsible for the content on this site.

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