Please use the following form to contact us with questions related to your case:

 

 

 Name:
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Date of Injury:
Describe Any Deadlines You Are Aware Of:
Any Orders or Decisions You Disagree With In The Last 60 Days:

Describe How The Accident or Injuries Happened:

Describe The Injuries That Resulted:

Describe All Companies or Persons Who Caused The Injuries:

What Medical Care Are You Receiving:

If Not Receiving Time-Loss, Why:

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Telephone:
(206) 447-1615 or (360) 331-4961
Facsimile:
(360) 331-7755

P. O. Box 625
Freeland, WA 98249

E-mail: moote@petermoote.com

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