Were you recently terminated, quit your job, or are you still employed?

When did you get terminated or quit your job?

How long were you working on the job before you were terminated or quit?

Approximately, when did you start working there?

What was your employment status?

What is your hourly wage?

This helps us understand what your potential case could be worth.

Was your meal or rest break ever missed, cut short, late, or interrupted?

Example: Your supervisor would ask you work related questions or for tasks during a break.

Were you required to complete work tasks before clocking in or after clocking out?

Example: Putting on a work uniform before clocking in or cleaning up after you clock out.

What is your annual salary?

This helps us understand what your potential case could be worth.

What state do you work in?

How many employees are in your company?

This helps us understand what your potential case could be worth.

Do you work for a government or a part of union?

Example: Working for USPS or part of a teacher's or construction union.

Do you believe you were discriminated against, sexually harassed, or retaliated against?

Select all that apply.

Do you have evidence of the discrimination, retaliation, protected activity, or harassment?

Example: Text-messages, emails, voicemails, phone calls, or witnesses.

Did you ever report the discrimination, retaliation, or harassment?

Tell us a little bit about what you are experiencing in the workplace?

Optional, but any information helps our team do research to build your case.

Were you ever injured on the job?

What is your preferred contact information?

This will remain completely confidential, but it helps us know how to address you.

What is your preferred contact time?

Lastly, please provide the company name of your employer:

Optional, but this helps our research team get you the most compensation.