KY INJURY HOTLINE KY INJURY HOTLINE FREE CASE EVALUATION FREE CASEEVALUATION Please provide accurate information to help us evaluate your case Personal Information I am over age 18 * Yes No Name * Phone * Email City * State * Incident Information Type of Incident * Select incident type Motor Vehicle Accident Slip and Fall Workplace Injury Medical Malpractice Product Liability Dog Bite Assault/Battery Other Date of Incident * Location Where Incident Occurred * Were You at Fault? * No Partially Yes Unsure Injury Information Type(s) of Injuries Sustained * Select all that apply Head/Brain Injury Neck Injury Back/Spine Injury Broken Bones Soft Tissue Burns Internal Injuries Psychological/PTSD Did You Seek Medical Treatment? * Yes No Additional Information Was There a Police Report Filed? Yes No Unsure Additional Information Submit This Form ©2025 Rick Hessig Law – In accordance with KBA regulations, we must inform you that case and court costs may be the responsibility of the client. Cookies | Privacy