Personal Injury & Litigation Assessment Form
To submit your case to Alexander Atkinson Law Corporation, please fill out the form below. You will be contacted as soon as possible.
Place (Province in Canada) of Accident:
British Columbia (BC) Other *If you select other then we may have to employ agents outside of British Columbia (BC) or Canada to represent you on your matter. You acknowledge that Alex Atkinson is only licensed to practice law in British Columbia (BC), Canada.
British Columbia (BC) Other
*If you select other then we may have to employ agents outside of British Columbia (BC) or Canada to represent you on your matter. You acknowledge that Alex Atkinson is only licensed to practice law in British Columbia (BC), Canada.
Type of Accident:
Assault & Battery Automobile Accident Slip & Fall Motor Cycle Accident Single Vehicle Accident
Describe what happened:
Date of Accident:
Describe injuries suffered:
Contact Information:
Name:
Company:
Address:
City:
Province:
Postal Code:
Phone No.
FAX:
E-mail:
How would you like to correspond:
Telephone Email Fax Mail
