Sacramento Office:
2150 River Plaza Drive, Suite 295 | Sacramento, CA 95833

Marysville Office:
630 B Street | Marysville, CA 95901

Toll Free: (888) WAY-2-WIN

Tel: (916) 564-5781 | Fax: (916) 564-2764

Personal Injury Attorney Consultation Form

Please fill out the following Case Evaluation form and provide as much information as possible. All information is kept strictly confidential and is used only by the Shergill Law Firm for the evaluation of your case. By accepting and reviewing this completed form, we are not agreeing to represent you. Rather, we will evaluate your information to determine whether or not we can accept your case.

Note: fields with a  *  are required.

 YOUR CONTACT INFORMATION
 * First and Last Name:
 * Telephone: - -
 * Email Address:
 YOUR INJURY INFORMATION
 * Date of Injury:
 * How were you injured:
 * Describe Your Injuries
  Other Comments:

**PLEASE DO NOT GIVE A WRITTEN OR RECORDED STATEMENT TO THE INSURANCE COMPANY!**


If you or a loved one has been injured in an accident
it is important to protect your legal rights.

Call Us Toll-Free:
1 (888) WAY-2-WIN
Tel: (916) 564-5781 | Fax: (916) 564-2764