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First Name *

Last Name *

Phone *

Email *

I agree to terms & conditions and privacy policy provided by the Twin Law LLC. By providing my phone number, I agree to receive text messages from the business related to my inquiry.

What type of accident were you in? *

Car

Motorcycle

18 Wheeler

Uber / Lyft / Rideshare

Construction

Bicycle/Pedestrian

Slip and Fall

Other

Brief Accident Explanation *

Were you injured? *

Yes, badly

Yes, minor injuries

No, I am not injured

Were you at fault for the accident? *

Yes

No

When did the accident happen? *

Within the last 14 days

Within the last 30 days

Within the last 6 months

Within the last 1 year

Within the last 2 years

More than 2 years ago

Where did the accident occur? *

Louisiana

Outside of Louisiana

Do you currently have a lawyer? *

Yes

Yes, but I am not happy with my current lawyer

No

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