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Personal Injury Questionnaire

Had an accident?
Need medical advice?.

Fill out the form below, click on the 'submit' button, and the details will be e-mailed to mailbox@swiftmedical.co.uk. You will not be charged for submitting this form.

Your Details
   
Name
Town
E-mail
Telephone Number
Accident details Please enter brief details of your accident in the box below, including the date of the accident.
 

We can only discuss your situation if your case can be brought in the courts in England and Wales - if you are in any doubt we will be able to let you know. Please note that any advice we give as a result of the details on this form will have to be of a general nature and cannot be relied upon exclusively unless and until we know more about the specifics of your case.

     
     
   
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