Report a Car/Motorcycle Accident

To report a slip and fall accident or other accident not involving a motor vehicle, click here


Dear Client / Prospective Client:

Provided below is a form for you to complete at the scene of the motor vehicle accident that will allow us to retain as much information about the incident as possible.

Please complete as much of the fields as you can.

Once you have completed the form, click on "Submit" to have the information sent to our office along with a copy to your submitted email.

Should you have any immediate needs, questions or concerns, do not hesitate to call us at (833) 625-3672.




Completion and submission of this form does not create any attorney-client relationship or obligation on the part of Khorshidi Law Firm, APC on behalf of prospective client. No attorney-client relationship exists until a contract is signed by a prospective client and the Khorshidi Law Firm, APC.

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