Consultation Request

Name *

First

Last
Email Address *
Are you seeing advice and/or representation for a business or an individual? *

Business / Employer Individual / Employee
Please provide the legal name of the business/employer (i.e., what company name appears on paychecks) : *
Please provide the location(s) of the business (for individuals, provide the locations(s) from which you worked): *
Does the company have over 14 employees? *

Yes No
What type of representation are you seeking? *

I need advice and/or assistance for my business regarding employee/HR issues. I need a lawyer to represent my business in an employment-related lawsuit, EEOC Charge or other matter. I am an individual/employee who wants to determine if I have any employment-related legal claims. I am an individual/employee with a pending EEOC Charge. I am an individual/employee seeking representation for severance negotiations. I am an individual/employee wanting to file a lawsuit against my employer/former employer. Other (please explain below)
Please tell me the types of legal issues that are involved : *

Discrimination - age Discrimination - gender Discrimination - race or national origin Discrimination - disability Discrimination - pregnancy Discrimination - religion Discrimination - other (please explain in the next section) Sexual Harassment at Work Hostile work environment / harassment based on age, gender, sexual orientation race, national origin, disability or religion. Hostile work environment / harassment - other (please explain below) Retaliation Breach of employment contract Severance / Settlement negotiations FMLA leave Pay / wage & hour issues HR advice for your business Drafting employee handbooks/policies/contracts Other (please explain below)
If you selected "other" under the representation and/or legal issues questions above (or if you need to elaborate on one of your responses), please briefly describe your need for legal services and the claim(s) you believe are involved:
Do you have any upcoming legal deadlines? (if so, please explain) *
Were you referred to me (if "yes," by whom?) *