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East Palestine Train Derailment Questionnaire - Welcome

Thank you for your interest in us representing you in this case. Our team is made up of some of the best lawyers across the country that have represented thousands of families and communities, and non-lawyers like public advocate Erin Brockovich who has spent her life fighting for families just like yours. 

There are a few steps to this process. The first step is to answer the following questions to help us see whether we are able to represent you in this case. If you qualify, we will have you complete our contract at the end of the qualification section. Our engagement team will be reaching out to you to gather additional necessary information in regards to your claim.

If at any point you prefer to talk to someone on the phone and go through this with them, you can call (330) 584-9084. Let's get started.

East Palestine Train Derailment Questionnaire - Qualification Questions

Do you have a suffix?*
Were you present for at least 8 hours within 20 miles of the Ohio Train Derailment between February 3, 2023 and February 8th, 2023?*
Do you have a fear that you will develop cancer someday due to your exposure to chemicals released as a result of the Ohio Train Derailment on February 3, 2023?
Did you experience any symptoms?
Which of the following symptoms did you experience?
Did you seek medical treatment?
Do you own a property within 10 miles of the Ohio Train Derailment on February 3, 2023?*
Did you lose commercial livestock with an uninsured value of at least $10,000.00 as a result of the Ohio Train Derailment on February 3, 2023?*
Will you be able to provide us with a copy of a driver's license or government ID which shows your current address, or, if not reflected on your license, any other document showing your residence?*

East Palestine Train Derailment Questionnaire - Qualification Status

Based on the information you provided, our team is able to represent you!

The next step in this process is to sign our Engagement Agreement. Once that is complete, you will have established an attorney-client relationship with us, which allows us to begin working on your case. After you submit your Engagement Agreement, we will be sending over your information to our case management team, who works on behalf of our lawyers to prepare your case. They are an amazing group of people from around the country that are dedicated to fighting for you for as long as it takes. Everything you did today will give them a great start. They will reach out to you to collect additional information and have you sign additional documents to allow us to represent you and if applicable your family in this case. Their phone number is (330) 470-8296. Please save the phone number so you know who is reaching out to you. 

Thank you for providing that information. Based on your answers, we have come to the unfortunate conclusion that we will not be able to represent you in this case. 

Please do not infer from our decision that you do not have a meritorious claim or could not prevail on your claim. We make no representations in this regard. Another attorney may disagree with our criteria and accept your case. We encourage you to seek legal advice from another attorney if you desire a second opinion as to whether you should pursue a claim. We regret that we are unable to proceed with your potential case.

East Palestine Train Derailment Questionnaire - Engagement Agreement


The undersigned “Clients”: (client’s printed name; or if deceased, name of client and decedent as: (client) individually and as representative of the estate and/or the successor in interest of (decedent)), hereby employs the Bevan & Associates LPA, Watts Guerra, LLC, Watts Guerra, LLP, Sunridge Law Group LLC, and the Law Office of Douglas Boxer called “the Firms,” as my attorneys to represent me in all claims, suits, or other matters arising out of and resulting from damages suffered by me or decedent related to the February 3, 2023 Norfolk Southern Corp. train derailment in East Palestine, Ohio.

1. THE FIRMS’ AUTHORITY. THE FIRMS’ AUTHORITY. Client fully authorizes and directs the Firms to manage and handle my claims as they deem proper and to investigate and prosecute them, with or without filing a lawsuit, in any manner they deem advisable. Client authorizes the Firms to deliver in my name any and all notices, receipts, authorizations, releases, pleadings and any other documents proper in and to the handling of my claims. Client authorizes the Firms to use their professional judgment and any relevant documents, records, or other information that the Firms deem necessary to proper representation of Client. If, at any time, the Firms determine, for any permissible reason, that prosecution of Client’s claims should be discontinued, the Firms may withdraw from my representation. Client understands and agrees that the Firms may transmit Client’s protected health information electronically in the course of representing Client. The Firms do not provide tax advice. THIS CONTRACT WILL BE VOIDED IF A SCIENTIFIC TEST DETERMINES THAT YOU DO NOT HAVE THE REQUISITE LEVEL OF EXPOSURE TO CERTAIN CHEMICALS AS DETERMINED BY WATTS GUERRA LLC

2. CLIENT’S COOPERATION. Client agrees to cooperate fully with the Firms, disclose all relevant facts and promptly advise the Firms of any change in address or telephone number, and to promptly comply with all reasonable requests of the Firms on all matters related to this contract. Client consents to being contacted by the Firms via telephone, text message, email, and specifically through the use of robocall technology as well as any other necessary methods of communication. Client understands that failure to fully cooperate may be a basis for termination of this contract. Client agrees not to attempt on his/her part to unilaterally settle the claims made the subject of this contract. The Client will rely exclusively upon the representation of the Firms during any settlement negotiations. No settlement will be made without the Client’s consent.

3. CONTINGENT FEE ARRANGEMENT. The Firms will assume joint responsibility for Client’s representation. In consideration of such legal services, Client hereby assigns and grants to the Firms the following percentage of any monies, interest, settlement, judgement, Court awarded costs or attorney fees or property recovered FORTY PERCENT (40%) or the maximum amount below that amount allowed by Federal Law. Client consents to the Firms’ sharing these attorneys’ fees 45.125% to Watts Guerra LLC, 2.375% to Watts Guerra LLP, 43.9375% to Sunridge Law Group, LLC and 3.5625% to the Law Office of Doug Boxer and 5% to Bevan & Associates LPA, Inc. Client consents to the Firms sharing their attorneys’ fees with local counsel as necessary. Attorneys’ fees will be determined before repayment of expenses; that is, attorneys’ fees will be calculated based on the gross recovery, before expenses are deducted. Client will receive all funds paid to Client by Client’s insurance company and no portion of insurance proceeds will be included in the contingent fee arrangement. This contingency fee is not set by law but is negotiable between the Attorney and Client. In the event there is no recovery, Client owes the Firms nothing.

4. EXPENSES PAID BY THE FIRMS. The Firms agree to advance any and all reasonable expenses associated with the prosecution of client’s claim. Expenses advanced by the Firms will be repaid to them from any recoveries made. In the event no recovery is made, no repayment of expenses advanced will be required. Advanced expenses that shall be reimbursed include office expenses attributable to the representation, other than general overhead expenses. Such reimbursable office expenses shall include, but are not limited to, internal document copying and scanning at $0.25 per page, document copying and scanning performed by others, photograph, video and document imaging expenses and reproduction thereof, mileage at the rate allowed by the Internal Revenue Service, travel, and all airfare, mileage, legal research and investigation charges, long distance telephone charges, fax and electronic mail expense and postage. The reimbursable expenses will also include any and all expenses or costs paid to or for persons, entities or businesses outside the firm which are related to the representation, including but not limited to, experts and their staffs; jury consultants; specialized legal counsel for bankruptcy proceedings initiated by defendants; Medicare/Medicaid, hospital lien, and subrogation resolution services; interpreters; investigators; court reporters; videographers; and document imaging companies and personnel. Regardless of outcome, Client will be responsible for all medical bills and liens incurred as a result of medical treatment received. Client understands the Firms may be representing multiple clients and agrees that in representing multiple clients many of the expenses incurred are common case expenses, which are costs and expenses incurred for the benefit of multiple clients, including expert witness fees, depositions of defendants, experts, and non-party witnesses, settlement conferences, trial expenses, filing fees, copy costs, and other expenses that are incurred for purposes of influencing the outcome of multiple clients’ claims. Client agrees the expenses that I am required to reimburse, if there is a recovery, include not only expenses for my own claims, but also client’s pro rata share of the common case expenses.

5. MULTIPLE CLIENTS. Client understands and agrees that the Firms may be representing more than one client in this matter and that the following aspects of joint representation have been disclosed: (1) the Client might gain or lose some advantages if represented by separate counsel; (2) the Firms cannot serve as an advocate for one client against another client; (3) the Firms must deal impartially with every client; (4) information received by the Firms from or on behalf of any jointly represented client concerning the matter may not be confidential or privileged as between the jointly-represented clients; and (5) if a conflict arises between clients, the Firms might not be able to continue representing any of the clients involved. Client consents to the Firms representing more than one client in this matter.

6. LAW AND VENUE. This agreement shall be governed by and interpreted under Ohio substantive law, and exclusive venue and jurisdiction of any lawsuit or claim arising out of or relating to this agreement shall lie in Ohio State Court in Columbiana County, Ohio. If any provision of this agreement shall be held to be invalid, illegal, unenforceable or in conflict with the law of any jurisdiction, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby.

7. NO SOLICITATION OF CLIENT. By signing and entering into this agreement, Client hereby affirms that Client’s case was not solicited by the Firms, the agreement is not being entered into as a result of promises of money, no promises of a successful recovery have been made to Client, and Client has freely and voluntarily entered into this agreement.



List the Names of Minors the Client is the custodial parent/guardian of, that Client is signing on behalf of

If Client has additional adult family members, Client’s adult family members will receive agreement to sign when Client speaks to case manager.

Use your mouse or finger to draw your signature above

East Palestine Train Derailment Questionnaire - Wrap Up

Thank you for trusting us to represent you and work on your claim. We will be here with you every step of the way. 

As a reminder our case management will be reaching out to you to collect additional information and documents. It is critical that you work with our case management team. This will allow us to continue to represent you. Their phone number is (330) 470-8296. Please expect their phone call. Lastly, you can visit our website at On our website you can see the latest media coverage, our legal team and FAQs. 

Thank you for your time today. We are thinking of you and your community and will be fighting for you every step of the way.