Online Case Assessment

Do I have a case?

Complete this free online case assessment form and a disability lawyer from Yazdani Law Office will contact you within 12 hours to discuss your case. No obligations. Just answers.

First Name:*

Last Name:*

Street Address:



Home Phone:*

Cell Phone:

Email Address:


Case Details

Name of Insurance Company:

Type of Insurance Policy:

Amount of Monthly Benefits:

Provide details about the medical condition and any symptoms that you are experiencing:

Provide details about the reason the Insurance Company or CPP denied your disability claim:

I acknowledge and agree that no lawyer-client relationship is established by submitting this online case assessment form
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