OTHER PERSONAL INJURY ENQUIRY

If you have suffered an injury in circumstances that do not fit one of our other personal injury enquiry categories, please complete the form below with some basic information about what happened.

Please tell us when and where the incident happened, briefly explain the circumstances, and describe the injury you suffered.

Completing this form does not mean that Rahim Ahmed Solicitors has accepted instructions to act for you. We will review the information provided and contact you to confirm whether we are able to assist.

First name

Last name

Email address

Telephone number

Who are you making this enquiry for?

Myself

A child

Another person

If you are making the enquiry for another person, what is your relationship to them?

Date of birth of the injured person

Day

Month

Year

Date of incident

Day

Month

Year

Where did the incident happen?

Name of the person, business or organisation you believe may be responsible, if known

Please briefly explain what happened

Please briefly describe the injuries you suffered

Is another solicitor or claims company currently acting for you in relation to this matter?

Yes

Is there anything else you think we should know about your enquiry?

I confirm that I have read the Privacy Notice and understand that Rahim Ahmed Solicitors will use the information I provide to consider and respond to my enquiry.