Case Submission Form

For a free, no-obligation consultation with an experienced attorney regarding cases of personal injury and wrongful death, please submit the following response form. We will respect the confidentiality of your information to the fullest extent. Form submissions are relayed to us through our highly secure servers.

If you prefer, you may contact us at 718-336-2000.

Tell us who you are and how we can contact you. Note: This information is strictly confidential and will not be communicated with anyone.

First Name

Last Name

Number, Street & Apt.

City

State

Zip

Email

Age

Occupation

Day Phone

Night Phone

Please provide a brief personal background of the person needing assistance. Many times we are contacted by someone other than the person in need of help, such as a parent on behalf of a child, or wife on behalf of a husband. Please provide the following information on behalf of the person who needs assistance.

The following information is for myself: Yes No

If "No" my relationship to the following person is:

First Name

Last Name

Why Do You Need Help? Please provide us with a very brief overview, in 200 words or less, describing in general the subject matter of your request. You can provide more detailed information below, but for now please confine yourself to providing us with a brief statement of the general facts of your case, injury and damages.

State the date you were injured.

What occurred?

Where did it happen? Please type in the City, County and State where it happened:
City
State
County

Who caused the harm? Please type in the names & addresses of all the wrongdoers involved:

What damages were suffered? Describe the damage you have suffered:

Has anyone already filed a suit? Yes No

When is the best time to reach you by telephone?

When the information you have provided is complete, please press the Submit button below to send it to Koenigsberg & Associates, P.C.. Your information will be kept strictly confidential.

Please know that you are not considered a client of our firm until your case has been accepted by us, and you have signed a formal "retainer agreement." No attorney-client relationship has been established until we have reviewed your case, decided to accept your case, and entered into a written representation/retainer agreement with the client.

The above is not legal advice. That can only come from a qualified attorney who is familiar with all the facts and circumstances of a particular, specific case and the relevant law. See Terms of Use.