Make a claim

Send us your Claim Form to provide us with brief details of your accident claim before having a chat with us.

We usually act "no win, no fee" in personal injury claims. This allows you to make a claim and to take it to court if you need to with no financial risk to you.

You can use this form to provide us with some information about any claims arising from

• Road traffic accidents
• Accidents at work
• Industrial disease
• Accidents abroad
• Medical negligence

Any information you provide will be treated in strictest confidence.

Fields marked with a * must be completed.

Your Details

Name: *

Address: *

Date of Birth (DD/MM/YY): *

Contact telephone number: *

Preferred call back time: *

Email address: *

Date of accident/injury (DD/MM/YY): *

Description of accident or other circumstances leading to claim: *

Mandatory: To help us distinguish between forms submitted by individuals and those automatically generated by spam software, please type the word shown here into the box below.