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Business & Corporate
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Condominium Law
Construction Law
Corporate Finance & Securities
Employment, Labour & Public Law
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Personal Injury
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$199,999 or less
$200,000 or more
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Please provide us with the full names and corporate names of all the parties involved (including yourself/ your company)
Please provide us with the municipal address where the work occurred and project name, if applicable
Personal Injury
What type of accident caused your injuries?
A Motor Vehicle Accident
A Slip and Fall
A Workplace Injury
A Dog Bite
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Have you applied for Accident Benefits through your insurer?
On what date did the accident occur?
MM slash DD slash YYYY
What injuries have you suffered?
Did, or have you been told, that you will need surgery as a result of your injuries?
If you are, or were working, what do you do for work?
Did you miss work because of your injuries?
Yes
No
How many weeks of work did you miss?
Please enter a number greater than or equal to
1
.
I have been off work since the accident and continue to be unable to work
Please provide all known information relating to the party which you believe caused your injuries, if no information is known, please indicate “unknown” in your reply.
Municipal, Land Development & Expropriation
Municipality & County (if applicable):
Other Allied Parties (if applicable):
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Critical Dates:
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Real Estate & Development
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If known, what is your expected timeline (or closing date)?
Employment, Labour & Public Law
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Harassment Complaint
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If a harassment/discrimination complaint, please provide a brief summary of the issue.
Student Program
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What year of law school are you currently in?
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Business & Corporate
Do you need assistance with: (select all that apply)
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Corporate reorganization
Drafting, reviewing or negotiating a contract
Buying or selling a business
Raising capital whether by debt or equity financing
Industry-specific regulatory or licensing advice
Governance of a for profit entity
Governance of a not-for-profit entity
Drafting, reviewing or negotiating a shareholder agreement, limited partnership agreement or other similar agreement
Do you currently operate a business?
Yes
No
What is the current structure (e.g., corporation, partnership, sole proprietorship)
Do you need assistance with governance?
Does your matter involve a dispute?
Is your matter time-sensitive? Please provide details.
Medical Malpractice
Name of Injured Person (if different from above)
First
Last
Date of Birth
MM slash DD slash YYYY
Address (if different from above)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Email (if different from above)
Phone number (if different from above)
Details of claim please tell us what happened, including dates
When did it happen?
Name(s) of the health care provider(s) who treated you
What do you think the health care providers did wrong?
Nature of injuries
Is your injury likely to be long term?
Yes
No
What type of injury do you have as a result of the medical treatment?
Please describe any of the physical activities that are now difficult to perform, including recreational and household tasks
Income loss were you employed before you were injured?
Yes
No
Has your injury impacted your ability to work?
Yes
No
How is your ability to work been impacted?
Cost of care
Do you have any ongoing medical expenses as a result of your injuries?
Yes
No
Please provide details
Have any family members had to spend time or money to help you with your care?
Yes
No
Please provide details
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