David Resnick & Associates, PC

Serving the metropolitan New York area and beyond.
450 7th Avenue, Suite 409 | New York, NY 10123
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Slip & Fall Evaluation

Contact Information
Name:
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About Your Injuries
Date of Accident:
Please Describe Your Injuries:

Was Hospital Care Required? Please Explain:

Are You Able To Work?

Please describe any permanent injuries:

   
About the Accident
Where did the accident occur, please be specific?

Did you notice any signs warning of property hazards?

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450 7th Avenue, Suite 409
New York, NY 10123