More Ways to Contact Us
For immediate assistance seven days a week, call
For general inquiries, e-mail
or use our main
Free Consultation for Elder Abuse/Neglect
Use this simple form to provide us with information that will help us prepare for your
. The information you are providing via this form shall be treated confidentially and is protected under the Attorney-Client privilege. Once received, we will phone you back at our earliest convenience. Please note that this form is for
elder abuse/neglect cases only
. Use these links for other types of cases:
Criminal or Federal Case
Personal Injury Case
Civil Defense Case
Juvenile Delinquency Case
Juvenile Dependency Case
indicates a required field.
Date of Birth
City, state, zip
(At least one phone number is required.
Use the format
Briefly explain what happened to the elder/dependent adult.
Have you reported the incident to the local police, Ombudsman's office, or Department of Public Health/Social Services?
Please provide the name of the agency contacted.
Describe the elder's/dependent adult's injuries.
Where is the elder/dependent adult currently living?
Information about the nursing home or person(s) (name and address) you believe committed the abuse
Please tell us how you found our web site.
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Other (please indicate):
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1440 N. Harbor Blvd., Ste. 900, Fullerton, CA 92835, Phone: (714) 961-1966, Fax: (714) 961-1972
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