Tell Us About Your Case

Name*
Street Address*
Apt #
City*
State*
Zip Code*
Phone Number*
Fax Number
E-mail address*
Age*
Were you injured? Yes  No 
What injuries do you have?
When did it happen?
Where did it happen?
Was an accident report prepared? Yes  No 
Do you have insurance? Yes  No 
If auto accident, is other party injured? Yes  No 
If workers compensation, was your employer informed? Yes  No 
How much time have you lost from work?
Did you go to the doctor? Yes  No 
Did you go to the hospital? Yes  No 
Do you presently have an attorney on this case? Yes  No 
Please describe what happened to you

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Lozner & Mastropietro
Attorneys at Law
The Lundy’s Building
1901 Emmons Avenue,
Suite 206
Brooklyn, New York (NY) 11235
718-615-0044
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Attorneys at Lozner & Mastropietro in Brooklyn, New York, serve clients in New York City, Brooklyn, Manhattan, Queens, Bronx, and throughout Kings County.

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