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ttorney Intake Questionnaire
Hello! I am eager to connect with you and see how I can support you. Please answer these few questions so I can better assist you when we connect. You are not alone! I got you!
What's your name?
What's your email?
What is your phone number?
Why are you seeking legal advice?
Because I have a current dispute with my employer I would like to resolve (I do not want to file a lawsuit).
Because I want to know if I have a case against my employer (I want to file a lawsuit).
How would you describe your employment dispute? Select all that apply.
My employer denied my request for a leave of absence.
My employer denied my request for accommodations.
My employer is not keeping the workplace safe and healthy.
I reported issues to my employer and I’m being retaliated against.
My employer treats me differently than my coworkers.
I was wrongfully terminated.
I was not returned to the same or a similar job after returning from leave.
I’m not getting paid for my work.
I’m being harassed.
Other employment dispute.
What is the name of the company you have a dispute with?
How many employees does this company have?
Less than 5
5 to 19
20 to 49
50 to 500
Over 500
Where is this company located?
If you have been fired, why do you believe you were fired? This may not be the reason your employer gave you, I want to know what YOUR belief is.
How can I help you?
Submit
