Personal Injury, General Contact Form

If you have lost a family member or suffered injuries as a result of another person's negligence or misconduct, working with an attorney who has exemplary legal skills can help you to achieve the favorable verdict or settlement to which you are entitled. To find out how our firm can work with you to address your immediate needs, contact us to schedule a consultation and case evaluation with an experienced personal injury attorney.

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Personal Injury Contact Form

Name

Email Address

Phone Number

When were you injured?

How did the accident/injury happen?

Where did the event occur?

Was the accident/injury work-related?
Yes No

Were there any witnesses to the occurrence?
Yes No

Was an investigation conducted (police or otherwise)?
Yes No

Did you do anything to cause the accident?

Did you know any of the parties involved, prior to the accident?

When did you first receive medical care for your injury?

What was your diagnosis?

What treatment have you received?

How has your lifestyle changed as a result of the accident?

DISCLAIMER: This site and any information contained herein are intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.

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Ripplinger & Zimmer, L.L.C.
2215 West Main Street
Belleville, IL 62226
Phone: 618-310-3306
Toll Free: 888-810-8209
Fax: 618-234-6728
Belleville Law Office

AMERICAN ASSOCIATION for JUSTICE Formerly the Association of Trial Lawyers of America (ATLA®) LEX THE MISSOURI BAR ILLINOIS STATE BAR ASSOCIATION

The law firm of Ripplinger & Zimmer, L.L.C., is located in Belleville, Illinois, and serves the communities of Illinois and Missouri, including St. Clair County, and the cities of Fairview Heights, O'Fallon, St. Louis, Chicago, Springfield, Peoria, Edwardsville, Champagne-Urbana, Bloomington, Danville, Kansas City, St. Charles, Alton, Decatur and East St. Louis.

CV, BV, and AV are registered certification marks of Reed Elsevier Properties Inc., used in accordance with the Martindale-Hubbell certification procedures, standards, and policies. Martindale-Hubbell is the facilitator of a peer review rating process. Ratings reflect the confidential opinions of members of the Bar and the judiciary. Martindale-Hubbell ratings fall into two categories - legal ability and general ethical standards.

Clients may be responsible for some costs and expenses associated with their case. The choice of a lawyer is an important decision and should not be based solely upon advertisements. This disclosure is required by rule of the Supreme Court of Missouri.