Law Offices of Ralph A. Russo
Workers' Compensation Specialist





Contact Us

Law Offices of Ralph A. Russo
49 Wells Street, Suite 212
Glastonbury, CT 06033
Phone: (860) 652-0480
Fax: (860) 652-0491
Email

*Name:
*Address:
*City:
*State:
*Zip:
*E-mail address:
*Home Phone:
Business Phone:
Cellular or Pager:
Facsimile:
Please provide the name and address of the employer involved:
Are you a current ______ of this employer?
employeeformer employeejob applicantprospective employee
Are you presently employed?
YesNo
If yes, please provide your job title and employer's name and address.
Can you be contacted at work?
YesNo
Describe your situation, including any relevant dates:
Are you a union member?
YesNo
If yes, provide the name, address, and local number:
Have you made a complaint about your situation to any governmental agency?
YesNo
If yes, provide the name of the agency, the date you made your complaint, and the final result, if any, of your complaint:
Are any other people involved?
YesNo
If yes, provide names, addresses (if known), and their relationship to you, if any:
Do you have any documents that could help explain your situation?
YesNo
If yes, list those documents and their dates:
Are there other documents that you do not have access to that could be of assistance?
YesNo
If yes, list those documents and their dates and locations (if known):
Describe how this situation has impacted you:
Describe what you would like to happen to resolve your issue (your preferred outcome):
Have other attorneys worked on this matter?
YesNo
If yes, provide names, addresses, and a brief description of their involvement:
Special concerns:
Where did you hear about this website?
 

NOTE: The use of the Internet for communications with the firm will not establish an attorney-client relationship and messages containing confidential or time-sensitive information should not be sent.

Contact the Law Offices of Ralph A. Russo today for a free initial consultation

Hartford County • Tolland County • Middlesex County
New Haven County

The law offices of Ralph A. Russo serve clients throughout Connecticut including Hartford, East Hartford, Manchester, Middletown, Waterbury, Norwich, New London, New Haven, New Britain, Norwalk and Meriden.

The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for individual advice regarding your own situation.

Copyright © 2008 by Law Offices of Ralph A. Russo. All rights reserved. You may reproduce materials available at this site for your own personal use and for non-commercial distribution. All copies must include this copyright statement.