Google Screened
Workers' Compensation and
Personal Injury Lawyers
in New Jersey
Free Consultation

Helpful Forms

Fighting for the injured in Southern and Central New Jersey

When you’ve been injured, you need an experienced attorney in your corner. At Kotlar, Hernandez & Cohen, LLC, we know the impact an injury can have on the lives of our clients. And we don’t rest until we resolve the case in a way that meets their needs.

Whether you are seeking workers’ compensation benefits or financial compensation after a personal injury accident, our attorneys are ready to go to bat for you. When we take your case, we finish what we started. Our legal team builds the strongest case possible. If the insurance company won’t agree to a favorable settlement, our trial attorneys are ready to fight for you in court.

Free Case Consultation
Hablamos Español

It’s always important for us to gather as much information as possible. During our investigation, we’ll review relevant documents and interview witnesses. But initially, a lot of that information comes from you. Below are various forms that will help our office serve your needs and build a strong case. Call us today to schedule a free consultation.

Workers’ Compensation

Accident Intake Sheet – Please bring to your initial consultation.

Medicare Release Form – If you are receiving Medicare benefits, please fill out this form (sign, date, date of injury & Medicare number) and bring it to your initial consultation or upon attorneys’ request.

Medical Authorization Sheet – Please complete upon attorneys’ request.

Claim Petition – Please sign & notarize upon attorneys’ request.

Application for Review – Upon attorneys’ request, complete within two years after your case is settled.

Personal Injury

Accident Intake Sheet – Please bring to your initial consultation.

856-751-7676 16000 Commerce Parkway
Suite C
Mt Laurel Township, NJ 08054 Monday - Friday | 8am - 5pm

856-751-7676 1913 Greentree Rd
Suite C
Cherry Hill, NJ 08003 Monday - Friday | 8am - 5pm

856-751-7676 1234 Bridgetown Pike
Suite 200
Feasterville-Trevose, PA 19053 Monday - Friday | 8am - 5pm

Trenton, NJ Office
Vineland, NJ Office