Please submit your potential claim for consideration using the form below. Do not forget to click the "submit" button below when you have completed your submission. If you do not consider the internet to be secure or if you prefer filling the form out on paper, you may print the form and mail or fax it to 1825 Market Center Blvd., Ste. 385, Dallas, TX 75207, fax: (214) 528-6511.

Once you submit this form, we will review it to determine whether representation may be appropriate for the law firm. Once we have read your submission you may be contacted by the law firm for more information or to arrange for representation. It is very important that you correctly list your email address and a phone number where you can be reached.

Submitting this form does not make you our client. You will only become our client after both you and Mr. Wiley sign a representation agreement. In any claim where we represent multiple victims, we will endeavor to keep your information confidential. However, we may share your information with other clients or potential clients if the information would be beneficial to their case.

If you understand and agree to the terms and conditions describe in this "About Your Submission" section, please complete the form below and return it to us by clicking "submit," by fax, or by mail.

Do not forget to click the "submit" button below when you have completed your submission.