Jump To Navigation
  • Super lawyers
  • American Board Of Trial Advocates
  • The Best Lawyers In America
  • Texas' Best Lawyers 2010 Edition
  • Life Member Million Dollar Advocates Forum The Top Trial Lawyers in America
Spinal Cord Injury Information Center

Spinal Cord Injuries Contact Form

*First Name

*Last Name

*Email Address

*Phone Number

*Zip

Street Address

Apt/Ste

Incident Street Address

Incident Apt/Ste

*Incident Zip

Business Phone

Cellular or Pager

Injury Information

Have you been diagnosed with a spinal cord injury?
Yes No

If so, please identify the type of injury (C4, T12, etc.)

What was the date and time of your injury?

Name, address, and phone number of your physician(s):

Was the injury complete or incomplete?

When and where were the following tests completed?

CT Scan
MRI
X-rays

Where did the accident occur?

Please describe the details of the accident.

Please provide the names of witnesses to the accident.

If an automobile was involved, please list the make, model and year.

If the accident occurred on a construction site, please provide the address and name of the site supervisor.

Please provide any other relevant information or concerns:

Copyright ©2009 FindLaw, a Thomson Business

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.

 
  • Museum District Office
  • 1150 Bissonnet
  • Houston, Texas 77005
  • Hartley Hampton
  • Toll Free: 866-635-0811
  • Phone: 713-574-8660
  • Fax: 713-650-6458
  • Email Us | Print Page
Areas We Serve

The Houston, Texas, law firm of Hartley Hampton, P.C., serves businesses and individuals in communities throughout south Texas in areas such as Bellaire, Baytown, Pasadena, La Porte, Alvin, Pearland, Lake Jackson, Conroe, the Woodlands, Tomball, Kingwood, League City, Humble, Galveston, Clear Lake, Friendswood, Texas City, Katy, West Houston, Orange, Beaumont, Port Arthur, Sugar Land, Missouri City, Victoria, Corpus Christi, Austin, San Antonio, Texas Gulf Coast and Dallas.

Harris County • Galveston County • Brazoria County • Matagorda County • Fort Bend County • Waller County • Grimes County • Walker County • Montgomery County • Liberty County • Chambers County • Jefferson County • Orange County

® by , a Thomson Reuters business.