Motor Vehicle Accident (MVA) Claim

Have you or a loved one been injured in a Motor Vehicle Accident (MVA)?
You may be eligible for compensation for medical expenses, lost wages, and pain and suffering. Complete the form below to find out if you qualify — it only takes a few minutes.

You may be entitled to compensation for:

Medical expenses and ongoing treatment
Lost wages or reduced earning capacity
Pain, suffering, and emotional distress
Vehicle damage and other related losses

"*" indicates required fields

First Name*

Last Name*

Email*

Home Phone*

Street Address

City

State*

Zip

Have you or a loved one suffered injuries in a motor vehicle accident (MVA)? You may be entitled to compensation.*

Notes regarding this claim

By submitting this form, you are agreeing to allow Goldtech Legal and their parent agencies to contact you at the phone number you supplied, even if it’s on a national or state Do-Not-Call List. Calls/texts may employ automated dialing technology and prerecorded/artificial voice messages and emails. You are also confirming that you understand that your consent is not a condition of any purchase or obligation, and that this submission does not form an attorney/client relationship.

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Motor Vehicle Accident (MVA) Claim

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