Worker's Compensation Attorney





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FREE PERSONAL INJURY SETTLEMENT EVALUATION: (What is my personal injury claim worth?)

This form will be emailed to our attorneys for their evaluation. Please also do not hesitate to contact us at 404-303-8400 or email Attorney Richard S. Griffin at richard@griffinlawfirmpc.com. A free phone consultation or your email will help us explore all of the facts of your case to better determine the true value of your claim.

First Name:
Last Name:
Address:
City:
State:
Zip:
Work Phone:
Home Phone:
Fax:
Email:
What is your accident date:
How the accident occurred:
Were you injured on the job while performing your job duties? :
Briefly describe your injures:
Did you notify your employer of the on the job injury?
Briefly describe the medical treatment you have received:
Are you disbled from work due to your injures?
Do the worker's compensation doctors given you a work excuse or work limitation?
Are you receiving income benefits (checks for your lost income)? If so, then how much?	How Much

Our attorneys will respond to your email or call as soon as possible with a full settlement evaluation.
The Griffin Law Firm, P.C. 2336 Wisteria Drive, Suite 540 Snellville, GA 30656 PHONE: (404) 303-8400 FAX: (678) 344-5152 E-mail us:info@griffinlawfirmpc.com