Reza Athari & Associates, Pllc
Licensed in Nevada

3365 Pepper Lane, Suite 102
Las Vegas, NV 89120
Tel: 702-727-7777
Fax: 702-458-8508



This information is Strictly Confidential


Name (Concerned Person):

E-mail Address:

Home Address :

Type of Work:

Home Telephone No.:

Work No.:

Date of Birth:


Date of Accident:

Where did accident take place? (Intersection)

Is this your first accident with injury?

If no, list all prior accidents/injuries.

List your injuries:

Were you transported by ambulance to the hospital?

If yes, what hospital?

Were the police called?

Do you have an accident report?

Who do the police say was at fault?

Do you have insurance?

Name of Insurance Company:

Did other driver have insurance?

Name of Ins. Company:

Free consultation is limited to 10 minutes to evaluate your case - NO FREE LEGAL ADVISE.
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Las Vegas, Nevada:
Reza Athari & Associates

3365 Pepper Lane, Suite 102
Las Vegas, NV 89120
Tel: (702) 727-7777
Fax: (702) 458-8508

Salt Lake City, Utah:
Immigration Law Offices of Reza Athari, PLLC

525 W 5300 S # 175
Murray,UT 84123
Tel: (801) 537-7777 
Fax: (801) 363-0506


San Diego, California:
Reza Athari & Associates

3444 Camino Del Rio North Suite # 103
San Diego, California 92108
Tell: (619) 284-8811
Fax: (619) 284-8822

St. George, Utah:
Immigration Law Offices of Reza Athari

1036 E. Red Hills Parkway, Suite D
St. George, UT 84770
Tel: (435) 656-1136
Fax: (435) 656-1145

Downtown Las Vegas location:
Reza Athari & Associates, Pllc

626 S 9th st Las Vegas Nevada 89101
Las Vegas, NV 89101
Tel: (702) 727-7777
Fax: (702) 458-8508

Reza Athari & Associates

Skype: Visasyperdones


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