Application | Graylock Services

It's Easy to Apply.

There are no fees or obligation to apply.

You also will not owe us anything if you lose your case.

If you have any questions, feel free to contact us anytime.

We are available 24 hours a day, 7 days a week to answer your questions.

Call us today at (800) 539-6470.

First Name

Last Name

Date of Birth

Email Address

Phone Number

Street Address

Zip Code

City

Please describe where you slipped and fell

Date of Incident

Do you have an Attorney?

Yes

No

Attorney’s Name

Attorney’s Phone Number

Would you like Graylock Services to recommend an attorney in your area that you can trust?

Yes, please help me find an attorney.

No thank you, I will find one on my own.

I have photos, or documents that I would like to submit with this application.

Provide us with any relevant documents and photos

From:

Upload Type

Document

Image

Select File

Upload another

Please describe the incident and the injuries suffered with as much detail as possible.

Your Application has been Successfully Submitted

An error has occurred. Please review you information entered