Telephone Consultation Request

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To request a consultation, please complete the form below. By submitting this form, you agree that all of the information provided is true and correct to the best of your knowledge. While all information will be kept strictly confidential, please note that your submission of this form does not mean you have retained us as your attorneys.

If your telephone consultation exceeds 30 minutes or will require the review of documents, a consultation fee may apply.

Please send documents to attorneyrakesh@gmail.com or by fax to 404-333-8529.

We will endeavor to contact you within 1 business day of receiving your completed form and documents.

Email *

Full Name *

(First, Middle, Last)

Street Address (Line 1) *

Street Address (Line 2) *

(City, State, and Zip Code)

Mobile Phone *

Alternate/Home Phone

Best Time(s) to Call You

Anytime

Morning (9:00 a.m.-12:00 p.m.)

Afternoon (12:00 p.m.-5:00 p.m.)

Evening (5:00 p.m.-9:00 p.m.)

Late Evening (9:00 p.m.-11:00 p.m.)

Employment Status? *

Still Employed (Full-Time)

Still Employed (Part-Time)

Still Employed (Demoted)

Laid Off/Reduction-in-Force

Fired/Terminated

Quit/Resigned

Furloughed

On Leave (e.g. disability, medical, personal, sick, PTO, etc.)

None of the above

Other:

Required

Name of your Current or Former Employer *

Hire Date (month + year) *

Separation Date (if applicable)

Current or Last Position Held *

How are/were you paid? *

Salary

Hourly

Both/Hybrid

Other:

Required

Please select all that apply to your situation: *

I have been discriminated against due to my race, gender, age, disability, pregnancy, religion, sexual orientation, and/or national origin.

I have been sexually harassed.

I have been retaliated against for complaining to my employer.

I have an employment-related contract or agreement that needs to be reviewed.

I was not paid a minimum wage or overtime.

I am/was a victim of workplace violence.

I need assistance with obtaining unemployment insurance.

I have a contract dispute I need assistance with.

I have a landlord/tenant issue.

I need assistance with a family law matter.

I have some other employment-related dispute or issue.

I have some other dispute or issue NOT related to my employment.

Other:

Required

Description of your situation. What happened? *

Status of your matter. *

I have complained to my employer (supervisor, boss, human resources, etc.)

I have filed an EEOC charge of discrimination.

I have filed a complaint/grievance with another federal, state, local, or administrative agency.

I have filed a lawsuit in federal or state court.

I have NOT filed any complaints, grievances or lawsuits regarding my matter.

Other:

Required

Are there any upcoming deadlines we should know about? *

Yes

Not Sure

Have you worked with another attorney on this matter? *

Yes

If yes, provide the name(s) of your current or former attorney(s).

Have you filed or been discharged from bankruptcy in the last 5 years? *

Yes

Is there any other information that you want us to know before the consultation call?

Send me a copy of my responses.

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