Parlatore Law Group is a Nationwide Distributed Firm
Please send all correspondence electronically
212-603-9918



 



Welcome to Parlatore Law Group 
We are committed to assisting you with your military medical malpractice claim. Our team, comprised of veterans and military family members, brings a unique perspective and dedication. We understand the challenges faced by military personnel and their families. Please fill in the following information to the best of your ability.

Disclaimer
Please be aware that the submission of the contact form does not constitute legal advice or form an attorney-client relationship. Parlatore Law Group cannot agree to represent you or to take your case simply because you complete this form or email the firm. Do not use the form below to submit confidential, privileged, or sensitive information. The information submitted on this form is not privileged. 

Contact information: Client Information Form

Emails
*
Upon submission, a copy of this form will be sent to the primary email.
Add email
Addresses
Add address
Phone numbers
Add phone number

If this is a wrongful death claim, please list your name as the client, with the decedent's name and your relationship with the decedent below.

Please enter N/A if not applicable

Please enter N/A if not applicable

Thank you so much for completing this intake questionnaire. This information will be extremely helpful in evaluating your case. We will contact you as soon as possible with any updates.

Please click the SUBMIT button below when you have finished answering all questions.