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Tampa Wrongful Death Attorneys Contact
Form
Wrongful Death Attorneys at the Tampa Office of Brooks Law
Group are willing to evaluate your potential wrongful death case
and discuss its merits and value with you. There is no charge
for our preliminary evaluation and discussion, but we do need
certain information from you to perform our evaluation. Once
we receive the information requested below, we will contact you
to discuss our evaluation. Again, there is no cost to you whatsoever
for this case evaluation.
If you are interested in receiving help on your potential
wrongful death claim, please provide us with the information
requested below. Please be sure to provide us with as much information
as is reasonably available. The quality of our evaluation is
dependent upon the accuracy of the information you provide to
us.
Click here if you prefer using our secure  Wrongful
Death Contact Form or
call the Wrongful Death Attorneys at the Tampa office of Brooks
Law Group at 863-299-1962, or e-mail ec3383@aol.com
Your full name:
(Required)
E-mail Address:
(Required)
Mailing Address:
(Required)
(Required)
Home Number:
Work Number:
Best time to reach you if you prefer a response by telephone:
How would you like for us to respond to you (e.g., telephone,
e-mail, regular mail, doesn't matter)?
What is the name of the person killed:
What was his or her age at death?
How are you related to this person?
Has probate begun or an estate been opened and, if so, who
is the personal representative of the estate?
What are the names, ages, and relationships of the deceased's
nearest relatives (spouse, children, parent, etc.)?
Describe the accident which caused the death as fully as possible:
Who do you believe was at fault in causing the death and what
do you believe they did wrong that would make them responsible?
Was the deceased person working before the accident which
caused his or her death and, if so, how was the person employed
and approximately how much did they earn per year.
Was the deceased person contributing to the support of, or
providing any special services to any other person during the
year before he or she died and, if so, what is the name and relationship
to the decedent?
Are there any other ways in which you or any other family
members or persons close to the decedent have been damaged or
harmed by the death?
Have you contacted any other lawyer about your potential claim
and, if so:
Did the lawyer agree to represent you?
Are you still being represented by the lawyer?
Are you now seeking a lawyer to represent you, or are you
just looking for a second opinion?
Do you owe any other lawyer a fee in this matter?
If we are willing to represent you, do you wish to employ
us?
Have you negotiated with any insurance company or any other
person in connection with this claim and, if so:
Are negotiations still ongoing?
What was the lowest settlement amount that you asked for?
What was the highest amount that you have been offered to
settle?
Have the medical or funeral bills or lost wages been paid
for by:
Workers Compensation?
Medicare, medicaid, or some other government program?
Employer's health plan?
Private insurance?
Are there any other questions you wish answered?
Is there any other information that you want to provide us?
Would you like to arrange a personal interview?
Are there any other instructions you wish to give us?
If you are finished, agree with the above, and want to send
this information by e-mail:
If you want to start over to correct or change information:
Final Instructions
INTERNET SECURITY: While we can keep any information received
in our office confidential, we cannot guarantee a secure transmission
over the internet. As such, should you have any questions as
to security or are otherwise concerned about transmission over
the internet, please print your information above and mail it
to us at:
The Brooks Law Group
123 First Street. N.
Winter Haven, Florida 33881
or call: 863-299-1962
SERVICES: When we receive the information from you,
we will evaluate the information and then either contact you
by mail at the address you provided or call you at the phone
number you have given us to tell you:
1. Our preliminary evaluation of your case
2. Whether we would be willing to represent you.
The information you have sent us may not be sufficient to
fully evaluate your matter.If more information is needed, we
will contact you to obtain the necessary additional information
before we give you our evaluation of your potential claim.
We will try to contact you by mail, telephone, or e-mail as
soon as possible. The necessity of providing service to our clients
may cause delay in answering your inquiry. If you haven't heard
from us in a reasonable time, please don't hesitate to call.
FEES: We charge no fee to provide the limited service
described above. If you decide to employ our firm to represent
you, we will provide contracts for you to read and sign. If we
represent you we are willing to do so on a "Contingent Fee"
basis, that is, you will owe us no fee for our services unless
we make a recovery for you, and in the event of a recovery, your
fee will be a percentage of the amount recovered, as outlined
in the written contract we will provide to you.
LIMITATIONS ON OUR SERVICE:
1. The advice we are able to provide is limited by the information
you provide. Final advice would be based upon a complete evaluation
of your case and cannot be accomplished with the limited information
provided above. A decision about a claim often can only be made
after a personal interview and a review of all records. Possibly
further investigation may not be necessary.
2. Your claim may be barred by the Statutes of Limitations.
These statutes provide that if an action is not filed within
a certain period of time, your claim may be forever barred. The
information you provide may be furnished so close to expiration
of the statute of limitations that we do not have time to provide
any assistance to you before time expires. By seeking our assistance,
you agree that we are not liable for failing to file a legal
action on your behalf or failing to take any other action on
your behalf.
3. You are certainly under no obligation to employ this firm
by sending us information. Conversly, we are under no obligation
to accept you as a client by our evaluation of your matter. We
reserve the right to to refuse to become involved in your evaluation
of your claim or in providing advice. If we do not contact you
within 5 days of your email, or decline to evaluate your case
or to represent you, you must not assume we have undertaken any
action or representation on your behalf. In that case you need
to immediately contact another attorney to protect your rights.
ADDITIONAL SERVICES: We are available to provide additional
services upon written or telephoned requests unless we advise
you of our decision not to represent you. Please feel free to
write us at our Winter Haven Office if more information is needed.
It is helpful to send along as much information as you have.
Any initial consultation with the Brooks Law Group is free.
For more information, contact us at 863-299-1962,
or by e-mail
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