Do you have a case?

Please give us some information so we may assess your case. 
The information you provide will be kept strictly confidential.

Name
Address
City State Zip
Phone
E-mail

 

Were you fired?  Yes  No   When?
 
If not fired, do you think you are about to be fired?  Yes  No  
When?
 
Were you given a reason for being fired/about to be fired? What reason?
Do you think it's really for a different reason? If so what reason?
 
Did you quit? Yes  No   When?
Why did you quit?
 
Were you or are you being harassed?   Yes  No
When was the last time?
What (briefly) constituted the harassment?
 
Why do you think you were being harassed? (race, age, gender, other - please name)
 
Did you report the discrimination or harassment to anyone in your company?   Yes  No
Who did you report it to?
What is their position?
Are they still employed there?   Yes  No
 
Did anyone witness the discrimination or harassment?  Yes  No
Who witnessed it?
What did they see or hear?
Are they still employed there?  Yes  No
 
Did you report the discrimination or harassment to any government agency?  Yes  No
Which agency?
When was it reported?
 
Did you file a written complaint?  Yes  No
 
Did you receive anything in writing notifying you that you can file a lawsuit?  Yes  No
When did you receive it?
 
Are you presently employed?  Yes  No
Where are you presently employed?
How long have you been employed?
What do you earn?
 
If you were fired or quit, how long were you there?
 
How much were you making?
 
Please indicate any other facts that you believe are important. We need to know what your employer did to you, what reason you think they did it which you believe it illegal, and what damage or loss you suffered because of what they did.

 

 

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