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Hixson & Brown, P.C.
1360 N.W. 121st Street, Suite A
Clive, IA 50325
Toll Free: (866) 654-3202
Fax: (515) 440-6395
Email
 
The Personal Injury and settlement attorneys  at the Hixson & Brown P.C. Law Firm are dedicated  to serve their clients in central Iowa, including the cities of Sioux City, Council Bluffs, Des Moines, Fort  Dodge, Ames, Cedar Rapids, Iowa City, Davenport, Dubuque, Waterloo and Burlington, and the communities  that make up Woodbury,  Pottawattamie, Polk, Webster, Story,  Linn, Johnson, Scott, Dubuque, Black  Hawk, and Des Moines counties.
 
Iowa Personal Injury Case Evaluation Form

If you would like one of our attorneys to contact you, you may complete the following case evaluation/information form. You may also choose to call us toll free at (888) 353-1904. Our regular office hours are Monday through Friday, 8:00 a.m. to 5:00 p.m.

Prior to reviewing information concerning your case, we will conduct a conflict of interest check to determine whether our firm has a conflict of interest because of a prior representation of the other party. If a conflict of interest is found, we will attempt to inform you of this conflict and your email will be deleted from our files. We reserve the right to decline representation for any reason.

The mere submission of this case form does not create an attorney-client relationship; nor does the absence of a conflict of interest create an attorney-client relationship.

Please note that a red asterisk (*) indicates required information.

* First Name  
Last Name  
Phone  
* Email  
State  
 
* Who Caused Injury or Incident/Accident?
Date of Injury or Incident/Accident?
Where did Injury or Incident/Accident Occur?
Please describe Injury or Incident/Accident:
Is there an insurance company involved? If so, what is their name?
Age of injured person:
Any additional facts we should know?
     
How did you hear about us?
 
We treat the information you provide to us as confidential. An attorney client relationship is not established by submitting this initial contact information to our office.
     
 
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