Toxic Mold Lawsuits:
The attorneys in our network represent people with mold claims throughout the country. Please fill out the information requested below for a no-cost legal assessment of your legal rights for health problems or property damage as a result of mold.
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Title:

First Name:

  M. I.

 

 Last Name:

 Address:

 City:

 State:

 Zip Code:

 Phone Number (day):

 Phone Number (eve):

Email Address 

 If this inquiry is not for yourself, please tell us the name of the person?:

 Title:

 

First Name:

   MI

 

Last Name:

What is the Injured's relationship to you?:

 Do you have a toxic mold problem at home or work? (please specify):

If at home, do you own or rent?

 If you rent, are there multiple units affected?

 If at work, are there other employees affected?

Has the property been tested for mold?:

 Yes No

If tested, do you have a copy of the report?:

Yes No

 Do you (or someone else) have health problems related to mold?

Yes No

 Has a doctor diagnosed your symptoms as related to mold exposure?

 What symptoms are you experiencing?

 

 Date of Diagnosis?

Do you have property damage over $5000? 

Please briefly describe your health issue and legal concern
 
 I understand that submitting this form does not create an attorney client relationship: Agree


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