Please complete the online medical/job questionnaire below prior to your appointment with one of our Social Security Disability attorneys. This form ensures we have all the information necessary to evaluate your case, and allows you to meet with an attorney as quickly as possible. Having more information about your case prior to the initial consultation means that your attorney will have more time to explain the Social Security Disability process, while also providing tailored advice about how to proceed with your claim.
Attorney Consultation Form
Our medical/job questionnaire is simple. You will need to list the jobs you have held in the past 15 years, identify your health care providers, and list your current medications. If a section of the intake form does not apply to you, feel free to skip It or write “N/A.” If you do not know the answer to a question, simply tell us “ I don’t know”. However, please note that only you can provide us your treating doctor’s names. If you cannot remember a particular provider, we suggest calling your primary care doctor to ask if they have a record of whom you have treated with.
Please note that filling out this form does NOT create an attorney-client relationship. The questionnaire simply lets us evaluate your case as efficiently as possible. Click hereto download our medical/job form prior to your consultation appointment or fill out our online questionnaire below.
"Everyone I dealt with from the K&T staff were great and I felt Mr. King was always on top of matters regarding my claim."Jim
"I refer cases to Kirk and Teff. Consistently their attorneys go above and beyond for our mutual clients. I highly recommend this law firm for Workers' Compensation and Social Security Disability claim ..."John D.
"I have used Kirk and Teff two different times. Everyone is friendly helpful and knowledgeable. I will continue to use them for any other law firm needs. And I would recommend them to anyone looking ..."Matthew F.
"Kirk and Teff has been by my side every step of the way after an unfortunate accident that has left me out of work for the past 5 months. They are very kind and very smart and diligently fighting for ..."Stephano V.
"Mr. Kirk is down-to-earth and easy to talk with. Jodi is an absolute gem, who has continuously gone to bat for me with any issues I have. I 100% recommend this law firm for anyone in need!"Henna J.