Update A Case Lawyer Line Intake First Name Last Name Email Cell PhoneImportant: If caller ID is different than the number they gave you, enter their caller ID number here:Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Reason for callDisqualifications: No injuries (i.e., property damage only) Caller is at fault. Not a case we accept (ie:, Criminal, Divorce, Bankruptcy, Medical Malpractice, Opioids) Incident occurred more than 5 years ago. Any injury at a Las Vegas hotel or casino. Intake Specialist* Status*StatusSign up package (the ACA was sent to lead)Turned down (auto send declination email)Fake (fake inquiry/spam)Wrong numberPendingUnable to reach attorneyCurrent ClientWas this a chat lead? Yes Potential Case? Choose a Case TypeCase TypeAuto accidentBicycle accidentDog biteMotorcycle accidentPedestrian accidentsProduct liabilitySlip & fallWorkers CompensationSexual AbusePremises LiabilityOtherDate of Injury MM slash DD slash YYYY Describe the circumstances surrounding the incident, and your injuries?What is the address or cross streets where the incident occurred? Please describe your injuries and how you were injured?Who was at fault for your injuries? (Name of person and/or company) Were you wearing your seatbelt? Did police or ambulance arrive at the scene? Did the police prepare a report and did the police issue a citation and, if so, to whom? Have you been in a hospital? What type of medical treatment did you receive? Where was the treatment received? (Facility, address, etc): Were there any witnesses? Do you have any photos from the incident? (scene, injuries) Have you received any settlement? Are you or have you been represented by a lawyer in this matter? Health Insurance On-the-job at the time of the incident? Were any others injured? If injury happened at someone's home, do they have homeowners insurance? Describe the incident and what caused itDo you have photos of the area? What type of property did this happen on? Was there an incident report filed? Was there a sign out warning of slippery and/or wet conditions? Was the caller a driver in the accident? If so, are they at fault? Were any others injured? Do you have car insurance? Does the other party have car insurance? What were the weather conditions outside? What time of day was it? Were there any passengers? Was anyone cited? What were you being treated for? When did negligence occur? Who was negligent? Did the negligent party admit to any fault? What injuries did you sustain? What is the prognosis for recovery? Where did this happen? Have any other providers commented on the negligent providers care? If yes, how so? What is the name of the owner of the dog that bit the caller? At what address were you bitten and under what circumstances were you there? What breed is the dog? Was the dog on a leash? Do you know where the dog is now? Have you already filed a report regarding this case? Who do you believe caused the wrongful death? How do you think that the involved party was responsible for the death of the relative? What effect did the product have that was dangerous? What kind of product is it and how is it used? When did you sustain the injuries from the product? When did you start using the product? When did you stop using the product? Do you have any packaging of any type left from the product? Were there any recalls on the product that you are aware of? List your injuries and how you were injured.Name of employer Location of employer Please describe the circumstances surrounding your claimPlease describe your injuries and how you were injured (sex crime)Name of abuser Relationship to abuser Ready to Sign Up Client? Script: This sounds like a viable case, let me get an attorney on the line to speak with you.Transfer To Attorney Major Case If the caller has a case that has large damages (i.e., broken bones, hospitalization, surgeries), clear liability, and insurance, please transfer to a major case lawyer below. Major Case LawyersMajor Case LawyersLamber GoodnowGallagher & Kennedy Sexual Molestation and/or Assault Breit Biniazan Kevin Biniazan Office: 757-670-3925 Mobile: 757-615-1553 kevin@bbtrial.com Lamber Goodnow Marc Lamber: Mobile: 602-793-9248 mlamber@fennemorelaw.com Jenny Pulliam Office: 602-916-5222 Mobile: 480-620-1472 jpulliam@fennemorelaw.com Gallagher & Kennedy Shannon Clark 480-861-3307 or 602-530-8194 Bob Boatman 602-330-7755 or 602-530-8340 Joseph Brown 623-340-4658 joseph.brown@gknet.com Eleanor Shaffer 480-336-0149 eleanor.shaffer@gknet.com Matt Boatman 480-612-4126 If not a major case (which is most cases), choose a state and transfer to an attorney below.State Where Injury OccurredStateArizonaColoradoIllinoisNevadaNative American LandOtherTransfer To Arizona Injury Law FirmArizona Injury Law FirmGoodnow McKayDonn CoolidgeZachar Law Firm Goodnow McKay Chris Goodnow Mobile: 602-826-5757 chris@goodnowmckay.com Justin McKay Office: 602-857-3234 justin@goodnowmckay.com Zachar Law Firm Main office number: 602-494-4800 (try first during regular business hours, receptionist will find who is available to take a call) Ben Jemsek: 602-705-7986 Dan Leffler: 602-319-4424 Anoop Bhatheja: 602-697-7697 Jim Abraham: 520-461-0821 Suzie Zachar-Hardy: 480-273-7562 Sara Thomas: 480-670-9080 Chris Zachar: 602-799-4801 Dave Catanese: 602-743-9166 Donn Coolidge Mobile: 480-510-4007 donn@coolidgeinjurylaw.com Transfer To Colorado Injury Law FirmColorado Injury Law FirmThe Gaiennie Law OfficeMcFarland Litigation PartnersMcFarland Litigation Partners Meredith Quinlivan Mobile: 303-349-3902 The Gaiennie Law Office 303-455-5030 (during working hours) 720-245-0545 (after hours) If issues with the lines above, call: Sabrina Cohen Mobile: 303-956-3879 sabrina@amyglaw.com Gorgy Alhasoon Mobile: 312-826-3521 gorgy@amyglaw.com Transfer To Illinois Injury Law FirmIllinois Injury Law FirmLevin Riback AdelmanLevin Riback Adelman Robert Adelman Mobile: 312-782-6060 radelman@lralegal.com Office line (9-5 M-F) Mobile: 312-782-6717 Adam Riback Mobile: 847-421-8841 ariback@lralegal.com Rick Levin Mobile: 847-651-6799 rlevin@lralegal.com Cheryl Kaniewski Mobile: 630-870-0567 Zach Levin Mobile: 847-651-5311 Jackson Swartout Mobile: 585-469-1006 Maya Kanaan Mobile: 630-506-0245 Transfer To Nevada Injury Law FirmNevada Injury Law FirmLagomarsino LawBehzadi Law OfficesLagomarsino Law Andre Lagomarsino Office: 702-383-2864 Mobile: 702-273-7660 aml@lagomarsinolaw.com Justin Bolor 702-480-5716 justin@lagomarsinolaw.com Denise Valdivia 702-461-7790 denise@lagomarsinolaw.comBehzadi Law Offices Qumars Behzadi Office: 702-643-4878 Mobile: 702-461-1647 q@behzadilaw.com Felicia Behzadi (assistant) felicia@behzadilaw.comTransfer To Native American/Indian Land Law FirmNative American Injury Law FirmTaylor & GomezTaylor & Gomez Dominic Gomez Office: 602-394-8930 dg@taylorgomez.com Transfer To Workers Compensation in ArizonaWorkers Compensation in ArizonaMatt Fendon Law GroupTransfer To Workers Compensation in IllinoisWorkers Compensation in IllinoisKreiter, Byck and Associates, LLCNo ACAs will be sent out for Paul Byck IL workers comp cases Paul Byck Kreiter, Byck and Associates, LLC Phone: 312-541-1145 Email: paul.byck@kbalawfirm.com Matt Fendon Law Group Matt Fendon Office: 602-562-9111 Cell: 602-391-9963 mfendon@fendonlaw.net Meghan Fawcett mfawcett@fendonlaw.net Nathan Zollinger nzollinger@fendonlaw.netOther state: Only Major Cases. Select a major case lawyer above. Known Conflicts (only a conflict if one of these entities caused the injury to the caller) Walmart Banner Health Systems Discount Tire Quiktrip Circle K Shamrock Farms Caesar’s Ent. Group MGM Ent. Group Harrah’s Ent. Group Intake NotesIntake Notes