Contact Us

Please fill out the following form and one of our personal injury attorneys will contact you shortly.
*Required Fields

* First Name:
* Last Name:
* Email:
* Phone:
Cell Phone:
Address:
Address 2:
City:
State:
Zip:
How do you prefer we contact you?

Best time to call:

How did you hear about us?
	TV Internet Other

Case Type:

In which city and state did the accident happen?

Date of accident:

Briefly explain your case:

* What animal is this?

"THE RESPECT YOU DEMAND. THE RESULTS YOU DESERVE."®

Balkin & Eisbrouch, LLC

A National Law Firm

"Making Things Right For Over 35 Years"

50 Main St., Suite 6

Hackensack, NJ 07601

Phone: 1-800-RESULTS

Fax: (201)457-3444