Accident Report Form

Did you have an accident (at work, traffic etc.) and would you like to receive a compensation? Please, fill in the form below in order to provide me all the necessary information that will help me to assess whether you can claim your loss. Please, try to provide as much information as you can.

Please, describe your accident in as many details as possible.

Please, provide other relevant information that you would like to share with us.

Please, provide any attachments that might be relevant to this case. It can be a witness statement, any contracts signed etc. Choose FilesNo Files ChosenAccepted file types: jpg, jpeg, jpe, png, pdf, doc, docx, xla, xls, xlt, xlw, xlsx, mp4, m4v. Max. file size: 23 MB

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Algemene Voorwaarden

Alexia Law is gevestigd in Amsterdam en ingeschreven in het handelsregister onder nummer 61452734. Alle diensten en (andere) werkzaamheden worden verricht uit hoofde van een overeenkomst tot opdracht met Alexia Law. Op alle rechtsverhoudingen zijn de algemene voorwaarden van Alexia Law van toepassing. Daarin is een aansprakelijkheidsbeperking opgenomen. Op de werkzaamheden van Alexia Law is tevens een kantoorklachtenregeling van toepassing. De voorwaarden en de kantoorklachtenregeling liggen ter inzage, zijn in te zien op www.alexia-law.com en worden op verzoek kosteloos toegezonden. De inhoud van dit bericht is uitsluitend bestemd voor de geadresseerde. Het gebruik van de inhoud van dit bericht door anderen zonder uitdrukkelijke goedkeuring van de afzender is niet toegestaan. Indien u niet de bedoelde geadresseerde bent, gelieve de afzender te waarschuwen.

Alexia Law is domiciled in Amsterdam and registered at the Chamber of Commerce under no. 61452734. All services and (other) activities are carried out by Alexia Law pursuant to a contract for professional services (“overeenkomst van opdracht”). Alexia’s Law general terms and conditions apply to the agreement, as well as Alexia’s Law office complaints procedure. These general terms and conditions and contain a limitation of liability clause and a jurisdiction clause electing the District Court of Amsterdam as the competent forum. The general terms and conditions and the office complaints procedure are at all times available for inspection, can be consulted at www.alexia-law.com and will be sent upon request free of charge. The contents of this e-mail message are solely intended for the addressee. Use of these contents by others without the prior approval of the sender or addressee, is not permitted. If you are not the intended addressee, please notify the sender immediately.

Download: Algemeene-Voorwaarden-Alexia-Law-pdf

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