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An attorney client relationship is not established by submitting this initial contact information to our office. This form is intended to assist BISNAR | CHASE with a preliminary evaluation of your case.

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Orange County Office
1301 Dove St, #120
Newport Beach, California 92660

Los Angeles County Office
1520 2nd Street, Penthouse
Santa Monica, CA 90401

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California Severe Head Injury Attorneys Disclaimer: The California brain injury, paralysis, head injury, closed head injury, spinal cord injury or other Orange County California personal injury legal information presented at this site should not be construed to be formal legal advice nor the formation of a lawyer or attorney client relationship. Any results set forth here were dependent on the facts of that case and the results will differ from case to case. Please contact a Riverside head injury lawyer or San Bernardino brain injury attorney at one of our Southern California law firm offices located in Los Angeles County, Orange County, San Diego, Riverside and San Bernardino. This web site is not intended to solicit clients for matters outside of the State of California, although we have relationships with attorneys and law firms throughout the United States.