Online Case Intake Form
Please fill out the following form to initiate the case intake process.
 Fields in yellow are required.*
TELL US ABOUT YOURSELF
Name:
Company Name:
How are you involved with this case?
Title:
Address:
City:
State:
Zip:
Please enter the phone number where you can be reached
 between 8:00 a.m. and 5:00 p.m. PDT, Monday through Friday:
Phone:  - 
Fax:  - 
Email:
TELL US ABOUT THE CASE
Name of Case:
VS
Project Involved in Case:
Project Location: City:

State:
Client:
(Company/individual requesting services for case)
  Expert Witness - Standard of Care   Expert Witness - Cost of Repair
  Destructive Testing   Other
Please provide details in the space provided below
 
Thank you for using our online case information form.
You will be contacted within the next few business days by an associate at SC Wright Construction, Inc. for further information about your case and to answer any questions you may have. If you have made the decision to retain SC Wright Construction, Inc. and would like for us to begin work on your case, continue to the next section. If you are only seeking information as to our services and capabilities, you may stop here. We look forward to speaking with you.
 
ADDITIONAL INFORMATION
 
If you have decided to retain our services and would like for SC Wright Construction, Inc. to open a job file for this case, we will need additional information for classification and billing purposes.

Only complete this section if you are ready for a file to be established. If you are only interested in information about our services and/or how we can help your case, you need only complete the previous section of this form.

Fields in yellow are required for work to begin.
 
CLIENT'S INSURANCE CARRIER
Primary Insurance Carrier: Address:
City: State:
Zip: Phone:
 - 
Fax: Email:
 - 
Claim Number or File Number: Insurance Adjuster:
There is an additional insurance carrier aligned with the client.
CLIENT'S ATTORNEY
      Tell us about the client's attorney(s):
Primary Law Firm Name Attorney Assigned to Case
Case Number Assigned by Firm:
(Required field only if no insurance claim
or file number is given) 		Address:
City: State:
Phone: Fax:
 -   - 
E Mail:  
If an additional law firm has been designated as co-counsel in this case check here :
DEPOSITORY
     If you know the depository designated for this case, enter information below:
Depository: City:
State: Phone:
 - 
Fax:
 - 
If you know who is retaining SCW (for billing purposes), select one of the options below:
BILL SCW SERVICES TO:

 Insurance Carrier  Law Firm/Attorney  Other
Thank you for using our online case processing form.
You will be contacted between 8:00 a.m. and 5:00 p.m. PDT the next business day by an associate at SC Wright Construction, Inc. to confirm the above information and answer any questions you may have.
 
CLEAR FORM SUBMIT FORM
URGENT SUBMIT
*IMMEDIATE ACTION REQUIRED

 Site Inspection Schedule  Emergency Repairs  Other