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DO I HAVE A CLAIM?

 

Most people have heard the term "Personal Injury", but do not fully understand what it means. "Personal Injury" includes all claims resulting in bodily injury, including psychological problems.

Some examples of, but not limited to, personal injury are;
Injuries sustained in an automobile collision.
Air bag fails to deploy.
Seat belt failure.
Slip and fall on slippery surfaces.

 

INJURY INFORMATION FORM

Injury Information
In what state did the injury occur?  
Injury Description
How where you injured?
Physician Information
Name:  
Address:
City:     State:        Zip:  
Tests Performed:
Was the injury reported to your employer?  Yes       No
Personal Information
Name:  
E-mail:
Address:
City:     State:       Zip:  
Home Phone Number: Work Phone Number:
SS Number: Birthday:

 

OUR TEAM

LARRY PITT

OFFICE MANAGER

FIRM PROFILE

DEPARTMENTS

WORKERS COMPENSATION

PERSONAL INJURY

SOCIAL SECURITY DISABILTY

IMMIGRATION

Main Office

1918 Pine St. Phila. PA. 19103
409-11 20th St. Phila. PA. 19146

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Contact Information

Phone: 1-215-546-0011
Toll Free: 1-888-PITT-LAW
Se Habla Español: 1-877-PITT-LEY
FAX: 1-215-546-0389
E-mail: lawyers@larrypitt.com

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