All information provided on these questionnaires are strictly covered under the Attorney-Client privilege, as you are seeking legal advice, and will be kept personal and confidential, regardless of whether you pursue a claim or not. However, please be advised that by providing this information you are not a client of Quintilone & Associates at this time. You may only become a client after a written agreement between yourself and a representative from Quintilone & Associates is executed.

As this questionnaire is used for a variety of cases, please disregard any questions that do not apply directly to your particular set of circumstances. Please be as accurate and concise as possible as this form is the primary resource we have to evaluate your potential claim(s).