Case Submission Form
For a free, no-obligation consultation with an experienced attorney regarding
cases of medical malpractice, please submit the following response form. We
will respect the confidentiality of your information to the fullest extent.
Form submissions are relayed to us through our highly secure servers.
If you prefer, you may contact us at (616) 458-2464 or Toll Free: (800) 272-4080.
Tell us who you are and how we can contact you. Note: This information is
strictly confidential and will not be communicated with anyone. It is necessary
only for purposes of enabling us to do a conflict of interest check prior to
responding to you. We cannot respond without being able to do our conflict
check. All BOLD fields are required.