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Email
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Your email
Name
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Your answer
Phone number
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Your answer
Address where incident(s) occurredÂ
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Your answer
What type of case do you have?
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Police misconduct/false arrest
Prison/Jail disregard for health or safety
Possibly wrongful death/negligence
Sexual harassment/hostile workplace/retaliation
Discrimination
Accused of a crime
Other
Other:
Tell us the details about your case. (Please tell us about your situation and include all the details, including what rights you believe have been violated. Include if any police reports or charges have been filed. There is no limit on the text in this section so please include all the details you can.)
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Your answer
What parties are involved? (If you are seeking to file a lawsuit, who is it against? For example: Police, government official, employer, prison, etc.)
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Your answer
What date did the incident occur?
MM
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DD
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YYYY
If multiple dates, list below or list duration of incidents.
Your answer
What kind of evidence do you have regarding the matter? Do you have any of the following: Police reports; video or audio recordings; photographs; medical records; other?
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How did you hear about us? If one of our clients referred you, please let us know. Also, please tell us if it was from a website or other source.
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A copy of your responses will be emailed to the address you provided.
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