Workplace Law Partners | Employee Potential Client Intake Form

Employee Potential Client Intake Form

Reach Out Today

We're Always Available To Help

A member of our team will be in touch shortly to confirm your contact details or address questions you may have.

First Name
Please enter your first name.
Last Name
Please enter your last name.
Phone
Please enter your phone number.

This isn't a valid phone number.
Email
Please enter your email address.

This isn't a valid email address.
Name of Employer
Please enter requested information.
Location You Worked
Please enter requested information.
Approximate Number of Employees
Please enter requested information.
Your position and general job duties/responsibilities
Please enter requested information.
Dates of Employment
Please enter requested information.
Please provide a summary of why you are seeking legal representation. It is important that you are detailed about what happened to you. Most people find it helpful to create a timeline of events beginning with when the issue began and up through the most recent events.
Please enter requested information.
Were you offered a severance?
Do you have a written employment contract?
Have you filed any complaints or charges with any government agencies?
Are there any deadlines of which you are aware? (e.g. 90-day right to sue letter; fact finding conference, etc.)
How much were you paid?
Were you paid hourly or salary?
Were you injured at work?
How many hours did you typically work each week?
For weeks where you worked more than 40 hours, do you get paid time and a half for those extra overtime hours? (If you never worked 40 hours, please leave this blank.)
Have you ever been paid additional amounts beyond your regular salary or hourly wage (e.g. shift differentials, safety pay, commissions, hazard pay)?
Does your employer use any biometric data (scans of your finger, face, eyes, voice, or any other body part) for any purpose?
Are you aware of anything illegal occurring at your job (for example, overbilling the government, lying to government?)
If we are not able to help you, it is ok if we share your information with another law firm who may be able to help
*Upload paystubs or other relevant documents.
Please upload your resume.
- By checking this box, you agree to be contacted by text message (SMS) about your request. Message frequency varies. Msg & data rates may apply. Text STOP to cancel. We do not share your phone number with any third parties for SMS purposes. Acceptable Use Policy

Please contact us for a free consultation with one of our intake professionals (this is a screening call, not for legal advice, and we do not provide opinions over the phone) concerning whistleblower, sexual harassment, wrongful termination, overtime, discrimination, non-competes, severance agreements, unpaid wages, pregnancy discrimination, or other matters so that we can see whether our employment lawyers will be able to assist you. Our Chicago, Illinois area employment lawyers love what they do!

Continue Reading Read Less