Start Here

Fill out the application below, and one of our team members will review it promptly.

First Name

Email Address

Last Name

Phone Number

Street Address

City

Zip Code

Please describe where you slipped and fell

Date of Incident required

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.

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

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

Pre-Settlement Funding Made Easy