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please complete and 'send page by email' to andrew.lewis@hattonssolicitors.com, fax to 01744 744404 or post to: Hattons Solicitors, Prudential Buildings, 3 Victoria Square, St Helens, Merseyside, WA10 1HQ To send send by email select Menu option File > Send > Page by E-mail - you will then be able to type in the boxes below. V.W.F. INITIAL ENQUIRY QUESTIONNAIRE |
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Full Name
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Email Address
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Telephone Numbers Home Work Mobile |
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Date of Birth
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Full Address Including Postcode
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How did you find out about our firm?
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Brief Employment History when tools were used Company Name and Years
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Types of Tools Used Including how often used ie. Daily, Weekly, Monthly
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Any Diagnosis of: V.W.F. If Yes, When ?
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Diagnosed by who ?
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Was it linked to your employment ?
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Any Diagnosis of: C.T.S. If Yes, When ?
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Diagnosed by who ?
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Was it linked to your employment ?
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Any C.T.S. Operations If Yes, When ?
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Any Diagnosis of: Reynauds If Yes, When ?
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Diagnosed by who ?
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Was it linked to your employment ?
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Have you ever sought legal advice on this matter before ? If Yes, When ?
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What Symptoms do you suffer from in your hands ? Pain Tingling Whiteness Numbness Pins & Needles
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online enquiry - vwfq.ver1 |