Matter Information: Employer/former employer name (company causing your issue): (Please note we will not contact this employer without your written permission)
Does the company have at least 15 employees total everywhere in the world?: Yes No Don’t know
In which Florida county did you work/apply for work?: The employer is: A private company A government entity Don't know
Nature of issue with employer (check as many as apply): Discrimination due to age, race, sex, religion, national origin, pregnancy, ethnicity, marital status, disability, color, genetic information, or sexual orientation Sexual harassment Employment contract Severance agreement Noncompete agreement Harassment due to age, race, sex, pregnancy, religion, national origin, ethnicity, marital status, disability,color, genetic information, sexual orientation Fired for making worker’s compensation claim Fired/retaliated against for whistleblowing or objecting to illegal practice of employer Discrimination due to military service Fired/retaliated against for jury duty Fired/retaliated against for taking medical leave Fired/retaliated against for serving as a witness to a lawsuit or providing testimony or evidence to a government agency (such as EEOC/OSHA/NLRB) Fired/retaliated against for having gun in vehicle at work Fired/retaliated against due to applying for a domestic violence injunction Fired/retaliated against due to discussing or objecting to working conditions with coworkers Employment-related defamation/libel/slander Fired/not hired due to credit history or background check Need help with unemployment appeal Wrongful termination Other employment law issue
What is the earliest date you learned you would be terminated, suspended, not hired or denied a promotion?: Have you filed a complaint regarding your situation with EEOC, NLRB, the Florida Commission on Human Relations, or other government agency?: Yes No
If so, which agency?: When did you file?: Has any other attorney worked on this matter for you?: Yes No
Please describe your situation briefly:
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