Philadelphia, PA 19103
Phone: 215-564-1233 Toll Free: 866-571-3772
Fax: 215-564-1225
Allentown, PA 18104
Phone: 610-366-7119 Toll Free: 888-288-3998
Fax: 610-366-2137

Please fill out this form to schedule a deposition:





Attorney Name *

Lawfirm *

Date of Deposition *

Time of Deposition *

Location *

Case Name *

# of Deponents *

# of Attorneys *

Insurance Carrier/Claim Number

Adjuster’s Name/Address

Notes/Claim Information/Special Services (i.e videographer, interpreter/language, ect)

Your Email *

Documents


*** This scheduling form will not be submitted unless all required fields are filled out.
You will receive a confirmation e-mail within 24 hours once your scheduling has been successfully submitted.
If you do not receive this confirmation, then please telephone ERSA at 215-564-1233 immediately.