Start Your Application TodayFast, secure, and no repayments until you win. Takes only 2 minutes. There was an error trying to submit your form. Please try again. How much $ would you like to borrow from your case? * This field is required. In which state did your incident occur? * Select an optionNew South WalesVictoriaQueenslandWestern AustraliaSouth AustraliaTasmaniaAustralian Capital TerritoryNorthern Territory This field is required. In which date did your incident occur? * mm/dd/yyyyThis field is required. What type of injury claim are you making? * Workplace Injury Slip & Fall Medical Negligence Car AccidentThis field is required. What type of treatment have you received? * Injections MRI Chiropractor Physical Therapy Physical Therapy Surgery Recommended for Surgery OtherThis field is required. Describe how you were injured? *This field is required. Have your received a prior cash advance on thei case from another company? * Yes NoThis field is required.What’s your name and how can we contact you? First Name * This field is required. Last Name * This field is required. Phone Number * This field is required. Email Address * This field is required.We need your lawyer’s information? Law Firm Name * This field is required. Lawyer Full Name * This field is required. Law Firm Number * This field is required. Law Firm Email * This field is required. Law Firm Physical Address * This field is required. Upload Client agreement from lawyer Click to upload or drag and drop This field is required. Upload Notice of claim Click to upload or drag and drop This field is required. Upload 100 points of ID Click to upload or drag and drop This field is required. Back Next Submit There was an error trying to submit your form. Please try again.