Case Submission Form

For a FREE consultation with an experienced attorney regarding cases of personal injury, 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 (813) 228-7070.

Tell us who you are and how we can contact you. Note: This information is strictly confidential and will not be communicated with anyone. It is necessary only for purposes of enabling us to do a conflict of interest check prior to responding to you. We cannot respond without being able to do our conflict check.

First Name

Last Name

Number, Street & Apt.

City

State

Zip

Email

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

Age

Occupation

For how long

Current or last employed

City and State where last employed

Highest grade completed

Schools/College attended

Degrees

Year degree granted

Special training or experience in

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 or when you first learned that you had been 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 The Gunn Law Group. Your information will be kept strictly confidential.

The Gunn Law Group handles cases involving Insurance Claims, Homeowners Insurance, Property Insurance Coverage and Disputes, Insurance Bad Faith, Hurricane Insurance Claims, as well as the most serious of Personal Injury such as: Automobile Accidents, Spinal Cord Injuries, Cerebral Palsy, Traumatic Brain Injuries, Medical Malpractice, Product Liability and Wrongful Death.

The Gunn Law Group serves the following Florida areas: Altamonte Springs, Apopka, Arcadia, Atlantic Beach, Bartow, Boca Raton, Bonita Springs, Boynton Beach, Bradenton, Brandon, Brooksville, Cape Coral, Casselberry, Clearwater, Cocoa, Cocoa Beach, Coral Gables, Coral Springs, Crestview, Crystal River, Dade City, Dania, Daytona Beach, Deerfield Beach, Deland, Delray Beach, Destin, Dunedin, Englewood, Eustis, Fernandina Beach, Fort Lauderdale, Fort Myers, Fort Pierce, Fort Walton Beach, Gainesville, Green Cove Springs, Gulf Breeze, Hallandale, Hialeah, Hollywood, Homestead, Hudson, Inverness, Islamorada, Jacksonville, Jacksonville Beach, Jupiter, Key Biscayne, Key Largo, Key West, Kissimmee, Lake City, Lake Mary, Lake Wales, Lake Worth, Lakeland, Largo, Leesburg, Live Oak, Longwood, Lutz, Maitland, Marathon, Marco Island, Melbourne, Merritt Island, Miami, Miami Beach, Milton, Mount Dora, Naples, New Port Richey, New Smyrna Beach, Niceville, North Fort Myers, North Miami Beach, North Palm Beach, Ocala, Okeechobee, Orange Park, Orlando, Ormond Beach, Oviedo, Palatka, Palm Bay, Palm Beach, Palm Beach Gardens, Palm City, Palm Coast, Palm Harbor, Panama City, Pensacola, Perry, Plant City, Pompano Beach, Ponte Vedra Beach, Port Charlotte, Port Richey, Port Saint Lucie, Punta Gorda, Quincy, Rockledge, Safety Harbor, Saint Augustine, Saint Petersburg, Sanford, Sanibel, Sarasota, Satellite Beach, Sebring, Seminole, Shalimar, Spring Hill, Stuart, Tallahassee, Tampa, Tarpon Springs, Tavares, Tavernier, Titusville, Venice, Vero Beach, West Palm Beach, Weston, Winter Haven, Winter Park, Winter Springs

Copyright 2008 © Gunn Law Group, P.A. , All Rights Reserved
Terms & Conditions Site Map