Contact

Waller Lansden does not agree to represent new clients through the internet without first having a face to face meeting, a telephone conversation, or an exchange of correspondence. If you would like to inquire about retaining Waller Lansden, please fill out the form below. Waller Lansden will conduct a conflict check (in order to make sure that we do not already represent an adverse party), and someone will be in touch with you shortly.

Please be advised that because of the need to obtain information from which to determine whether a conflict of interest or a potential conflict exists, the information divulged preliminarily for this purpose will not be confidential, and that Waller Lansden would not be barred as a result of receiving the information from representing another client if a conflict of interest or potential conflict is found to exist, or if for other reasons no representation is undertaken. By sending information on this form, you expressly acknowledge that the information is not confidential.

There may be important deadlines involved in your claim. If you fail to file suit or take other appropriate action in a timely manner, you may lose permanently some, if not all, of your rights.

Information about you:

First Name:

Last Name:

Alias (if one exists):

Street Address:

Apt | Suite | P.O. Box:

City:

State:

Zip:

Phone Number w/ Area Code:

Email Address:

Information about adverse and/or potentially adverse parties or interests:

If Individual(s):

First Name:

Last Name:

Alias (if one exists):

Additional Individual(s)(if any):

First Name:

Last Name:

Alias (if one exists):

If Business:

Exact business or corporate names:

Street Address:

Apt | Suite | P.O. Box:

City:

State:

Zip:

Additional Business (if any):

Exact business or corporate names:

Street Address:

Apt | Suite | P.O. Box:

City:

State:

Zip:

Please give a brief description (75 words or less) of the nature of your matter: