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Wrongful Death Information Center

Wrongful Death Contact Form

*First Name

*Last Name

*Email Address

*Phone Number


Street Address


Incident Street Address

Incident Apt/Ste

*Incident Zip

How are you related to the decedent (the person who passed away)?

Have you been appointed as the personal representative or executor of the decedent's estate?
Yes  No 

When did the decedent die?

What was the cause of death?

Was an autopsy conducted?
Yes  No 

Was the decedent married or single?
Married  Single 

Is the decedent a minor?
Yes  No 

Did the decedent leave children?
Yes  No 

Was the decedent employed at the time of death?
Yes  No 

Were you dependent upon the decedent for financial support?
Yes  No 

Were other family members dependent upon the decedent for financial support?
Yes  No 

Do you have reason to believe the decedent experienced pain or suffering as a result of an incident that contributed to his/her death?
Yes  No 

Did an accident occur which caused the death?
Yes  No 

Is there any indication that the poor medical treatment contributed to cause the decedent's death?
Yes  No 

Please note any other concerns:

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  • 1150 Bissonnet
  • Houston, Texas 77005
  • Hartley Hampton
  • Toll Free: 866-635-0811
  • Phone: 713-574-8660
  • Fax: 713-650-6458
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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.

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