Consultation – Degeyter Law Firm- Disability Help Houston

Schedule a free consultation by calling us at (713) 485-0610 or send us a message on our Contact page, and then fill out the form below

Visit Contact Page

Consultation Pre-Screening Form

Please fill out this form before attending a free consultation with our experts. This will help us collect necessary information beforehand, in order to make the best use of our time.

Name
First Last
Age
Phone
Email
Please list all health conditions that keep you from working
When did you last work?
Are you seeing a doctor?
- Yes
- No
Have you worked 5 of the past 10 years?
- Yes
- No
Are you currently receiving Social Security benefits?
- Yes
- No
Is someone currently assisting you with a Social Security claim?
- Yes
- No