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Accident compensation advice & personal injury claim enquiry

WorkCover / work, motor vehicle, public Liability, negligence, criminal compensation & Other injuries 

* indicates mandatory fields, write "no info" if nothing to input
Title
First Name *
Last Name *
Email *
Date of Birth *
Home Phone Number *
Mobile / Cell Phone Number *
Home Fax Number *
Home Address *
City *
State *
Post / Zip code *
Country *
Work Phone Number *
Work Fax Number *
Work Address *
City *
State *
Post / Zip code *
Country *

Preferred Contact Method *
Home Phone
Email
Work Phone

Accident Details

Time and date of accident *
Precise place of accident *

Type of accident *
WorkCover / Work
Road / Motor Vehicle
Public Place
Product
Other

Summary of the accident *

Other Comments

Photo of Injury if available, for multiple images select most important,
or zip the images and attach the zip file

Attach File (20Mb Limit) *

Enter Word Verification in box below *

Accident Compensation Advice services are not limited to clients from Queensland Australia. Interstate and International visitors to Queensland Australia may be eligible for personal injury compensation relating to motor vehicle / road accidents, WorkCover / work accidents or some other form of personal injury compensation claim.

Accident Compensation Advice (Queensland injury law specialists) personal injury claim services may provide assistance through its affiliates in personal injury matters that occured in other states of Australia or other countries.
[contact us without delay as time limits may apply]



Please note:By submitting the personal injury enquiry form it must be considered we are not retained or liable. We are not retained until we have an agreement in place.We will respond by your preferred method of contact as specified. This will only occur following a thorough investigation of this matter.

Until we have responded and entered into a Solicitor / Client agreement, it must be considered we are not retained.

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