Clinical negligence enquiry form

The clinical negligence team meets every Thursday to discuss potential new cases. Please fill in this form to submit your details.

Full name (Required)

Contact telephone number (Required)

Address (Required)

Email address (Required)

Are you making this enquiry on behalf of:

Date of birth of the injured person

Do you or the injured person have any dependents i.e children or partner?

What date did the injury happen?

Do you have a solicitor acting for you at the moment?

If yes, please provide the name of the solicitor (we will not contact them without your permission)

Please tell us why you think you may have a legal claim for compensation, and against whom (Required)

Please read our privacy statement to understand how your personal information may be stored and used by Leigh Day & Co solicitors.

Please press send to submit your details