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Wisner Baum Wisner Baum
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Complete Our Questionnaire

If you don’t have an answer for a specific field, please type “N/A” for not applicable.

  • Please enter your first name.
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    • Type of injury or loss -- please check all that apply

    • Personal Injury
    • Wrongful Death
    • Property Damage
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  • Injuries

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    • Prior to the fire, did you or anyone in your family suffer from any of the following? Check all that apply

    • Asthma
    • COPD
    • Other Pulmonary Condition
    • No Pulmonary Condition
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  • Property Damage

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    If you have a copy, will you please send it to us?
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    • Do you have any videos, photos or an inventory of your property prior to the fire? Check all that apply.

      If you have any of these items, please reserve them for our firm. Also, if you do not have an inventory of lost items, please begin creating one now.
    • Videos
    • Photos
    • Inventory of lost items
    • None of the above
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  • Business Loss

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  • Employment

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