Ricci, Grube, Aita & Breneman PLLC
Construction Law & Construction Defect Litigation

Experience • Dedication • Integrity • Quality

A Seattle Litigation Firm
1200 Fifth Avenue
Suite 625
Seattle, WA 98101
Phone (206) 770-7606 ext. 102
Fax (206) 770-7607

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Seattle WA Drug Injury Attorney Federal Way Washington Car Wreck Attorney Ricci, Grube, Aita & Breneman PLLC

A Seattle Litigation Law Firm

Seattle personal injury lawyer Scott Breneman of Ricci, Grube, Aita & Breneman PLLC represents injured people and grieving families who have suffered the loss of a loved one in a wrongful death or suffered a serious personal injury. The firm serves clients in Seattle, Washington, and throughout the greater Puget Sound area from Tacoma to Everett, including the communities of Redmond, Kirkland, Federal Way, Kent, Renton, Shoreline, Mercer Island, and Ballard in King County, Snohomish County, and Pierce County.

1601 Second Avenue, Suite 1080
Seattle, WA 98101

Ricci Grube Aita Breneman PLC

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*Name:
*Address:
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*E-mail address:
*Home Phone:
Business Phone:
Cellular or Pager:
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Who was injured?
If "Other ", please describe:
Injured person's name (if different from above):
Address:
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When did the injury occur?
Where did the injury occur?
Was this location the injured person's
If "Workplace," did the injury occur as a result of employment activities?
YesNo
If "Other," was this a road accident?
YesNo
If no, did the injury occur on another's property?
YesNo
If yes, who owns the property?
How did the injury happen?
What were the surrounding circumstances (weather, lighting, slipperiness, other)?
Were there witnesses to the injury?
YesNo
If yes, what are their names/contact information?
Were others involved or injured at the same time?
YesNo
If yes, what are their names/contact information?
Was there a police report?
YesNo
Did the injured person receive medical treatment?
YesNo
If yes, provide dates, locations, provider names, and details:
Is the injured person still receiving treatment?
YesNo
Was the injured person killed as a result of the accident?
YesNo
If yes, what was the date of his or her death?
Describe lifestyle changes experienced by the injured person and his or her family as a result of the accident:
Describe other losses resulting from the injury (lost wages, damaged property, other):
Where did you hear about this website?
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NOTE: The use of the Internet for communications with the Breneman Law Firm will not establish an attorney-client relationship, and messages containing confidential or time-sensitive information should not be sent.  An attorney-client relationship with the Breneman Law Firm may be established only by an engagement letter signed by a lawyer of the Breneman Law Firm.

Phone (206) 224-1650 • Fax (206) 224-7011

The use of the Internet for communications with the law firm of Ricci Grube Aita & Breneman PLLC will not establish an attorney-client relationship, and messages containing confidential or time-sensitive information should not be sent. An attorney-client relationship with the the firm may be established only by an engagement letter signed by a lawyer of the firm.