Social Security Questionnaire

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Please fill out the form below the instructions

This informal questionnaire that follows is intended to provide our firm with information so that we can assess which Social Security Disability option might work best for you.

Our firm offers two alternatives for you to enlist our help in your Social Security Disability situation.  Firstly, you can have a free telephone discussion with one of our Social Security Disability attorneys about your matter.  In order to have a free telephone conversation, you will need to fill out and submit all the sections of the Questionnaire that apply to you.

Secondly, we can meet with you in person (or even by internet-based conference) for a free 30-minute consultation.  In advance of that consultation, you will need to fill out and submit the Social Security Disability Questionnaire below.  Please complete all the required questions below.

The questionnaire can also be sent to you via facsimile, or you can stop into any one of our offices to pick up a copy.  Likewise, you can return a SSDI questionnaire to us via facsimile (407-578-2181) or you can drop it off at one of our offices, and an attorney will call you within 1 business day of receipt for your free telephone review.

Please note that neither the holding of a consultation, the completion of the above questionnaire, nor merely contacting Bogin, Munns & Munns, P.A. in the manner that you have creates an attorney-client relationship with you. Bogin, Munns & Munns, P.A. cannot represent you until the firm knows there would not be a conflict of interest, and the firm determines that it is otherwise able to accept the engagement. Any information or documents sent prior to your executing an engagement letter and submission of any required retainer deposit cannot be treated as protected by an attorney client privilege and may be determined by a court to not constitute protected information of any nature. We will only become your attorneys once you have signed an engagement letter, and our firm’s fees and costs have been paid. Nothing herein is intended as legal advice, nor should you consider it as such unless otherwise directed. It is intended only as general information with respect to a question that you have raised regarding this legal matter. You should not act upon any information herein without retaining professional legal counsel.