Attorneys Referral Form

Here are several scenarios where a partnership with the Law Office of W. Shane Jennings can be highly beneficial: If you encounter a case outside your area of practice, need assistance in reducing medical debt, or are managing a personal injury case with a multiple injury conflict, we are equipped to help.

Additionally, if your client requires boutique injury representation, or if you’re facing an overwhelming caseload, retiring, or seeking co-counsel, collaborating with us not only ensures the best outcome for your clients but also allows you to manage your practice more efficiently, enhancing your reputation and client relationships. Together, we can deliver superior legal support for every client.

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Date of Referral *

Referring Lawyer

Attorney First Name *

Attorney Last Name *

Referring Attorney Email *

Email

Confirm Email

Phone *

Law Firm Name (If applicable)

Referred Individual Information

Approx Date of Accident, Event or Incident *

Client First Name

Client Last Name

Referred Client Email *

Email

Confirm Email

Phone *

Represented by Counsel? *NoYes

Statute of Limitations date approaching quickly? *noyes

Case Information

Dropdown *Auto AccidentCriminalCivilFamilyPersonal InjuryProbateWillOther

Case or Claim Number (if applicable)

Jurisdiction *

Brief Case Description *

Why are you referring this case? *Conflict of InterestClient’s Best InterestComplication of CaseFee Referral (Only)Multi-Client CaseOutside of Practice AreaPro Hac ViceRetiringWitness RepresentationWorkloadOther

Instructions of Lawyer

Special Instructions or Urgent Needs

Is their any urgency in this case that needs to be disclosed? *NoneSOLActive LitigationPending HearingClient is infirmedHigh Conflict Opposing CounselAttorney issueOther (please describe in text box)

Other Reason

Additional Information

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