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Personal Injury Intake Form

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Tell Us About Your Personal Injury Case

Life for an injury victim often times becomes much more difficult after the injury, and the extent of one's injuries is not always clear until days or even months after the incident occurs. Not only does the victim suffer physically (and possibly mentally) as a result of an injury, but now the victim or a representative must deal with doctors, insurance companies, and possibly attorneys. Each of the parties involved will require the victim or a representative to provide them with documentation. If you are an injury victim and planning to file a claim, your attorney will ask a number of detailed questions; so preparing early will make the process much easier (while helping you remember key details). Please note that completion of this form does not bind legal representation. Upon completion of this confidential form, you will be contacted by an attorney to discuss your case.
  • List the names, addresses, and telephone numbers of all insurance companies that may be involved (including, as applicable, automobile insurer, health insurer, disability insurer, homeowner's insurer, etc.). | Health Insurance Company: | Automobile Insurance Company: | Local Insurance Agent (if any):
  • This field is for validation purposes and should be left unchanged.

Awards & Accolades

 
Marc E. Chapdelaine
 
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Testimonials

  • I am impressed with the professionalism, depth of legal knowledge and the ability to use this in the case strategy. I are most impressed with our win at the District Court of Appeals which to me demonstrates Attorney Chapdelaine's broad legal skills set. I would highly recommend Attorney Chapdelaine when legal representation is crucial in you life.

  • Excellent Attorney! Highly recommend! He listens to your issues and he's confident and amazing in Court.

  • Marc and his team are true professionals in every sense. He communicates well and answers questions fully and in a timely manner. Have never had a difficult time reaching him or one of his team and they were always respectful, kind., and trustworthy. A true pleasure doing business with them.

  • Attorneys Marc Chapdelaine and Timothy Ryan truly fit the ideal definition of what outstanding representatives in court mean. From start to finish, both gentlemen exceeded expectation with their professionalism, impressive knowledge and their sincere...

  • Marc was referred to me by a buddy, at the time I had already interviewed multiple attorneys and promised another I would hire him. After speaking to Marc I called the previous lawyer to apologize, I hired Marc and do no regret it. Marcs knowledge wa...

  • Always available, professional and thorough. And a great guy!

Chapdelaine Law Office

325 Central Street
Saugus, Massachusetts 01906

781-233-1112 Phone