Initial Enquiry Form - Your Claim Lawyers

Thanks for contacting Your Claim Lawyers. Please provide some further information to assist our lawyers in reviewing your claim, so that we can provide tailored advice when we speak with you.

About You

Your Name(Required)

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How Can We Reach You?

We would love to chat with you. How can we get in touch?

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Your Email Address(Required)

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Your Phone(Required)

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How was your injury sustained?

Please limit your response to the specific details of the incident – for example: ‘I was driving westbound on Smith Street when another car ran a red light and t-boned my vehicle’ or ‘I was lifting a box of car parts weighing 30kg at work when I felt a pain in my lower back’

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What injury/ies did you sustain?

What injury/ies have you been diagnosed with as a result of the incident?

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Upload Documents

Please upload any relevant documents that may assist our lawyers to review your enquiry. This may include medical certificates, photographs of injuries or accidents, specialist reports etc.

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Max. file size: 8 MB, Max. files: 10.