north carolinasouth carolina
Professional Licensing Issues Submission Form

   We are anxious to help you.  There are two ways you can contact us about your case.  You can either call us at 1.800.556.8404 to talk to one of our client service representatives or you can fill out the on-line form below and submit it to us from this website at any time.  After completing the form you may submit it by simply clicking on the I AGREE button after reading our necessary disclaimer. 



Personal Information

Your last Name   Your First Name   Your Gender  

Physical Address (Include City, State, Zip)  
Email Address    
Cell Phone (xxx-xxx-xxxx)   Home Phone (xxx-xxx-xxxx)   Work Phone (xxx-xxx-xxxx)  

 

Details Information

Employer:  
Type of license held/wanted:  
Date license issued:  
Explain nature of professional licensing issue:
Have you received notice of a hearing/meeting with a licensing board?
 
Have you received notice of your appeal rights?
 
Have you viewed our tutorial on professional licensing issues?
 
Are you presently represented by an attorney?
 

 

Disclaimer
WARNING:
If you are a Pre-Paid Legal Services, Inc. Member you may not use this method of seeking legal assistance. You must call the 1.800 number on your membership card. If you submit a request in this manner we will not be able to process you as a Pre-Paid Legal member which could result in significant delays.
     
Disclaimer:    
Before you can submit your case for potential review, you must read and agree to the following: "I understand that by submitting this information to MFWWC, I have not created an attorney/client relationship with MFWWC and that MFWWC has no responsibility to protect my interests in this matter in any way unless and until I enter into a signed, written fee agreement with MFWWC. I understand that MFWWC has no obligation to reply to this email and are not responsible for this matter. By clicking on the I Agree button below, I hereby submit my information on this basis and certify that I have read the GENERAL Disclaimer."  





  When you need legal help, we are here to serve you.