Skip to main content
Home page
Site map
Search
Contact Us

Home Lawyers for People

Personal Injury

Criminal Injury Compensation Authority

Complete the detailed criminal injury claims form

Personal Injury

Criminal Injury Claims

Please complete the Criminal Injury Claims form below. Questions marked * must be completed but the more you can tell us about your injuries and how you got them, the more advice and help we can give. If you provide your phone number, we will only call you to discuss this enquiry.

Please call us on the freephone number 0800 3899 096 if you would prefer to talk to one of our Personal Injury specialist solicitors and lawyers in confidence.

Personal Details

Forename ^*

Surname ^*

Email Address ^*

Home Telephone

Mobile Telephone

Best time to call?

From time to time Lawson-West may wish to contact you with special offers or other information that may be of interest to you. Please indicate whether or not you are happy to receive such communication from Lawson-West.

Yes
No

Accident Details

A) What was the date of your accident? (dd/mm/yyyy)

B) Where did the accident happen?

C) Did you inform the Police? Yes
No

D) How did the accident happen?

E) What was your injury?

F) When did you go to your GP/Hospital?: ^* (1) Within 24 hours
(2) Within 1 week
(3) Longer than 1 week
(4) Not at all

G) Any Additional Information

Please ensure that you have completed all the required fields (marked with *) and then click submit to send the form.

Excellent legal services from specialist solicitors & lawyers

"I have been more than satisfied with the way my accident claim was handled, and the service I received. Thank you."

Mrs W, Thringstone, Leicestershire, June 2010

See more Lawson-West Testimonials »

© Lawson-West 2010

Terms & Conditions

created by studio-40