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Litigation Contact Form

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Cellular or Pager

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Have you used any other personal name(s) in the last six years? If yes, please list here

Are you employed?
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If yes, please list the name and address of your employer

Please describe the legal issue in question

Does the claim involve a personal injury?
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If yes, please describe the injury

Did you require medical treatment?
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If yes, please describe the treatment

Please list any medical providers (doctors, clinics, hospitals) who have treated your injuries:

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Office Locations

The Law Firm of Peters & Wasilefski

2931 North Front Street
Harrisburg, Pennsylvania 17110

Telephone: (717) 260-3483
Fax: (717) 238-7750
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