Truck Accident Evaluation

If you or a loved one has been injured or killed in a trucking accident, you should contact an experienced accident attorney who can help explain your legal rights and options. Large trucking companies have their own investigators and attorneys fighting for them - you need someone on your side. Contact us today, and someone will be in touch with you shortly.

*Title: -- Mr. Mrs. Ms. Miss Mr. & Mrs. Dr.

*First Name:

MI:

*Last Name:

*E-mail Address:

*Retype E-mail:

Home Phone:

Mobile Phone:

Work Phone:ext.

*Provide at least 1 phone number.

Street Address:

Apt/Suite:

City:

State/Zip  /

What is the best way to reach you?

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Additional Contact Information:

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Date of Accident:

Time of Accident:

City where Accident occurred:

State where Accident occurred:

Location of Accident?

Do you have copy of police report? Yes No

Is an attorney currently representing you for this matter? Yes No

How did accident occur?:

What injuries resulted from accident?:

Name of your auto insurance company:

Other party's auto insurance company:

Name of your health insurance company:

Other forms of medical coverage company:

Medical expenses to date:

If yes, when did you stop working?:

Approximate Money Lost Due to Injury:

Describe Car damage and/or other property damage:

Car rental and/or transportation costs:

Other Information:

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If you have been injured in a trucking accident in northeastern North Carolina, including Williamston, Edenton, Elizabeth City, or on the Outer Banks, contact the law offices of Teague & Glover today at 252-335-0878 to speak to an experienced trucking-accident attorney. Contact Us Online