Hi! I'm Emily R. with The Finkel Firm.

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Best Time To Contact

(Select all that apply)

9 AM -12 PM

12 PM - 3 PM

3 PM - 6 PM

⚠️ Please note: You only have a few weeks after receiving the notice of termination to take action against it and protect your rights.

Pick one of the case types below.

If you're not sure or more than 1 apply - don't worry! Just choose one for now.

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Discrimination (age, disability, medical, pregnancy)

Sexual Harassment

Wrongful Termination

Retaliation (for making complaints)

What did you complain about?

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Did you make your complaint(s) in writing?

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Yes

What adverse action was taken against you?

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Select all that apply

Termination

Demotion

Reduced Hours

None

Why do you believe you were terminated?

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How long were you employed

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When were you employed?

Approximate date of hire

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Approximate date of termination

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Who sexually harassed you?

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Supervisor/Manager

Co-worker

What type of sexual harassment occurred?

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Select all that apply

Physical (unwanted touching, gestures)

Verbal (comments, jokes, requests)

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Which of these do you have as proof of the harassment?

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Select all that apply

Text Messages

Emails

Photos

No Evidence

Did you report the harassment to the company?

Please select a date

Yes

Was your report made in writing?

Please select a date

Yes

Which of these categories of discrimination applies to you?

Please select a date

Select all that apply

Age (50+)

Disability or Medical Condition

Pregnancy

Please describe the discrimination you experienced.

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What is your current employment status with this employer?

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Still Employed

Terminated

Resigned/Quit

Laid Off

What was your last day of work?

Please select a date.

How long were you employed

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What is your current employment status with the company?

Please choose an option

Still Employed

Terminated

Resigned/Quit

Laid Off

What was your last day of work?

Please select a date.

Anything else about your case you want to share?

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Please confirm your information

First name

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Last name

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Email address

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Phone number

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I acknowledge that this form is for initial case evaluation purposes only. Submitting this form does not create an attorney-client relationship. All information provided will be kept confidential.

@How-Long-Employed+@discrim-How-Long-Employed1+@discrim-employment-status1+@discrimination-type+@employment-status+@harassment-by-who+@harassment-evidence+@harassment-report-in-writing+@harassment-reported+@harassment-type+@retaliation-action-type+@retaliation-in-writing

Reviewing your answers…

We’re evaluating your responses to match you with the right team member.

Thank you, @fname

A member of our team and will be in contact soon.

Inquiry

Initial Assessment

Phone Call

Best Time To Contact

⚠️ Please note: You only have a few weeks after receiving the notice of termination to take action against it and protect your rights.

Pick one of the case types below.

If you're not sure or more than 1 apply - don't worry! Just choose one for now.

What did you complain about?

Did you make your complaint(s) in writing?

What adverse action was taken against you?

Why do you believe you were terminated?

How long were you employed

When were you employed?

Who sexually harassed you?

What type of sexual harassment occurred?

Which of these do you have as proof of the harassment?

Did you report the harassment to the company?

Was your report made in writing?

Which of these categories of discrimination applies to you?

Please describe the discrimination you experienced.

What is your current employment status with this employer?

What was your last day of work?

How long were you employed

What is your current employment status with the company?

What was your last day of work?

Anything else about your case you want to share?

Please confirm your information

Reviewing your answers…

Thank you, @fname

A member of our team and will be in contact soon.

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