Wrongful Death Questionnaire

New York Personal Injury and Wrongful Death Law Firm

Michael W. Goldstein, Esq. has been practicing New York personal injury law, including accidental injuries causing wrongful death, since 1979. If a close relative of yours died as a result of an accident or medical malpractice, the family may be entitled to receive money damages. We invite you to complete and submit the form below, to see if we can help to obtain monetary compensation for your tragic loss.

Your Name (required)

Your Email (required)


Your Relationship to Deceased

Age of Deceased

Date of Death

Date of Accident

Location of Accident

Describe the Accident

Describe the Injuries and Treatment Before Death



Please click the Submit button. If you do not receive a confirmation message, an error has occurred. Therefore, kindly confirm the required fields (including Name and Email) and verify the security code. Then please submit this form again, or click the reverse arrow in your browser. If you are unable to successfully submit this form, please call us.

Notice: Your submission of this Questionnaire, or a free telephone consultation, will not constitute an attorney-client relationship.

New York Injury and Wrongful Death Attorney Disclaimer

The New York personal injury legal information contained in this website is not intended to constitute legal advice, nor to create an attorney-client relationship or lawyer-client relationship. We recommend that you discuss your loved one’s Wrongful Death case with a Wrongful Death Attorney or Accident Lawyer promptly, since there are strict time limitations that apply to New York Wrongful Death and injury lawsuits. This website is not intended to solicit clients for Wrongful Death accident cases outside of New York State.

New York Personal Injury Lawyer and Injury Attorney representing accident victims who have sustained serious injuries, and the families of victims of Wrongful Death in New York City, Manhattan, Bronx, Brooklyn, Queens, Staten Island, Long Island, Nassau County, Suffolk County, Westchester County, Rockland County and upstate New York.

Law Offices of Michael W. Goldstein

New York Personal Injury and Wrongful Death Law Firm

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