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The Law Offices of Kenneth M. Rodgers

Your Philadelphia Injury Lawyer

 Are you injured?
Toll Free
1(855) LAW-PLUS 		Or call locally
1(215) 923-3330

This form is provided for you to help me in evaluating your claim. Please submit it with as many details as possible. If you experience any difficulty with this form, please contact me at krodgers@lawrodgers.com or by phone at 215-923-3330.

Submit Free Case Evaluation

Your name*
Street address
City
State
Zip
Phone*
Email
Date of Injury (approximate -- dd/mm/yyyy)
Type of injury (i.e. broken ankle, back injury, etc.)*
Where did the injury occur
Parties you believe to be responsible and why
What action other lawyers have taken about your potential claim
Medical care to date
Time missed from work as a result of the injury

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The Law Offices of Kenneth M. Rodgers, PC | 1818 Market Street, 13th Floor | Philadelphia, PA 19103
Copyright © 2011 Kenneth M. Rodgers

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Car Accident Injuries
Workers' Compensation
Social Security Disability
Dangerous Drugs
Side Effects
Defective Medical Devices
Product Liability
Medical Malpractice
Cerebral Palsy
Birth Injuries
Asbestos / Mesothelioma
Dog Bite Injuries
Slip And Fall
Lead Paint
Motorcycle Accident
Rhino ATV Accident
Pedestrian Accident
Trucking Accidents
Defective Products
Premises Liability
Traumatic Brain Injury