In the last 3 years have you been injured in an accident that wasn't your fault? YES NO
 
Did you receive professional medical attention for the injury? YES NO
 
Have you already made a compensation claim for this injury? YES NO
 
Where was your injury? (PLEASE SELECT)
Head Neck Shoulder Back
Arm Elbow Wrist Hand
Pelvis/Hip Knee Leg Ankle
 
Your Title:      
First Name:  Surname:
Home Phone: E-Mail Address:
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Berkleys Solicitors is authorised and  regulated
by the Solicitors  Regulation Authority (SRA)
No. 490629

 

 

Berkleys Solicitors
  Balfour House, 3rd Floor, 741 High Road, Finchley, London N12 0BP   Tel: 0208 445 3440   Fax: 0208 174 0611   info@berkleyssolicitors.co.uk