Gruhin & Gruhin Medical Malpractice Inquiry Form

Gruhin & Gruhin, Attorneys ^{© 2000}
MEDICAL MALPRACTICE INQUIRY FORM

If you would like to be contacted
please complete the form

            Your name:

            Your email address:

           Your Telephone Number & Area Code: We will try to call you to discuss this claim.

            Date you became aware of the malpractice:

           Please describe the malpractice in as much detail
         as possible:    Give dates, Doctors - Hospitals involved, medical procedures,
                                            and what, in your opinion, went wrong



         Please note:  You must be a resident of the State of
                           Ohio or the malpractice must have taken
                           place in the State of Ohio in order for us
                           to respond to this inquiry.

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Please note that unless you are a current client of Gruhin & Gruhin,
this transmission does not create an attorney-client relationship.
Pursuant to Ohio Law, Gruhin & Gruhin does not represent anyone
without a signed contract for legal services.

Answers provided to any *email legal inquiries* are provided as
general information only.

If you need legal advice for a specific legal problem, dealing with an
Ohio injury claim, an in depth consultation is necessary.

Please call or email to schedule a free initial consultation so that we
can discuss the complete event & review any relevant papers.
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This form is the property of Gruhin & Gruhin, Attorneys
Unauthorized use or duplication is forbidden ^{© 2000}