We want to talk to you about your appeal…

Please complete this form so a Disability Advocate can contact you to discuss your case in detail. All of the information you provide will be considered confidential and will not be shared with anyone without your consent.

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The following information is some of what is necessary to complete your appeal. Please note, more information will be needed but will be obtained in direct contact with you.


This information is considered confidential regardless of whether or not Starr Disability Advocates represents you. Your information will not be shared with any other resource without your permission.

DISCLAIMER: The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Time-sensitive information should not be sent through this form.