Lead Intake Case Details Case Type* Marketing Source* Marketing ID Client Reference Injured Party Information First Name* Middle Name Last Name* Phone* Email* Address* City* State* Zip Code* SSN* Gender* --MaleFemale Date of Birth* Other Names (AKA) Marital Status Spouse Name Deceased Information Is Deceased?* NoYes Deceased Date Caller (OBO Injured Party) Caller First Name Caller Last Name Relationship Reason for Legal Authority Injury Fortnite Grand Theft Auto (GTA 5) Minecraft Roblox Call of Duty Other Case Notes Contract Signed Date* Attachments You can select multiple files. SLP accepts one file per request, so we send each file sequentially after the case is accepted. Submit Case