Medical Malpractice Attorney in Los Angeles

Please help us understand a little bit more about your case by providing the following information (if not provided in your email):

Name

Email**

Phone Number*

Type of Injury*

Injury

Death

Date of Injury/Death

Please state the date you believe negligence occurred. In a death case, please provide the date of death.

Details*

Check All That are True

There is a Death Certificate

An Autopsy Was Conducted

You Have Medical/Treatment Records

Upload Copy of the Autopsy

Accepted file types: pdf, jpg, png, Max. file size: 50 MB.

If you have a copy, please upload it here.

Who performed the Autopsy?*

Who performed it(LA County Coroner, Post Autopsy Services, other)

Medical Records*

Please list the following: 1) from what health care providers?, and 2) How you obtained the records.

What Hospital/Facility Did This Happen?*

Please describe what happened*

Details*

Check All That are True

You Have Medical/Treatment Records

Medical Records*

Please list the following: 1) from what health care providers?, and 2) How you obtained the records.

What Hospital/Facility Did This Happen?*

Please describe what happened*

Is there A Current Course of Treatment?*

Yes - Permanent

Yes - Temporary

Current Treatment*

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