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Potential New Client Intake Form

The first step to obtaining legal representation from our firm is to complete the following intake form. The information provided on this form will be kept strictly confidential. Filing out this form does not create an attorney/client relationship. Please note that civil rights claims have strict filing deadlines.

Contact Information:
Do You Identify as Any of the Following?
Are You Contacting Us About an Employer?
What Best Describes the Size of the Employer?
Please Describe How Your Compensation is Determined
Were You Required to Clock in/out Using Your Finger, Eye Scan, or Other Biometrics for Purposes of Timekeeping, Logging Into Systems, or Otherwise?
If Yes, Did You Consent in Writing to the Collection of Such Biometrics?
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Were You Offered a Severance or Separation Agreement?
Did You Sign the Severance or Separation Agreement?
Have You Applied for Unemployment Compensation?
If Yes, Please Describe the Status of Your Application (Pending, Approved, Hearing Scheduled, Appeal, Etc.)
If Still Employed, Are You Looking to Leave The Company?
What Best Describes Your Most Recent Performance Review?
Have You Previously Worked With an Attorney on This Matter?
Have You Filed a Legal Action in Court or an Administrative Agency Related to the Legal Problem Described Above?
If You Have Filed With the EEOC or State Agency, has a Notice of the Right to Sue Been Obtained?
Have You Ever Filed a Claim Against Another Employer?
 

Please do not include any confidential or sensitive information in this form. This form sends information by non-encrypted e-mail which is not secure.

Submitting this form does not create an attorney-client relationship.

Client Reviews
★★★★★
"Alexander is my attorney who has been thorough, aggressive, focused, and a credit to the legal profession. Five months ago Alex was thrown into my case due to a tragedy by my previous lawyer. He was given few records, learned the circumstances, and devoted his attention so that this week he stood before a judge to try my case. Well done Alexander!" Allan Zwirn
★★★★★
"Alex is an outstanding lawyer well knowledgeable and very professional I do not usually recommend lawyers to family members or friends but I definitely would recommend Alex thanks for a great job well done." Winston, R.
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