Contact Information
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Information Regarding Injury
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Fault
Was the other Drivers Fault ?Yes   No
Did the other driver receive a ticket (hazardous action) Yes   No  
Was a Police report made ? Yes   No  
Do you have a copy of the report ? Yes   No
 
Injuries
Did you go to the emergency room? Yes    No
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FRIED SAPERSTEIN ABBATT P.C.

29800 Telegraph Rd. Southfield, Michigan 48034

Telephone : (248) 353 6500
E-mail : info@fsalawfirm.com

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