Your Information

Preferred Method of Contact:

Select an option Email Phone Call Text Message

Are you contacting us on behalf of a business/entity?

Yes

Business Legal Name: Type of Entity (e.g., LLC, Corp): Your Title/Role:

No

_________________________________________________________

Opposing Party / Other Parties Involved

Full Name of Opposing Person or Company:

Your Relationship to Opposing Party:

(e.g., Employer, Landlord, Business Partner)

Opposing Party's Attorney:

(if known)

_________________________________________________________

Your Case Details

What type of legal matter is this?

Select an option Employment Civil Rights Contract or Money Owed Government Agency Decision I have been sued or accused Other (please specify below)

If other, please specify:

Detailed Narrative:

Describe what happened in chronological order, in your own words. Include dates, names, and job titles. Do not paste in a summary written by an AI tool — write it yourself.

Date of the primary incident(s):

Date you were first harmed or became aware of the issue:

Has any lawsuit, arbitration, or administrative case been filed — either by you or against you?

No

Yes

Who filed it, and what is the case or claim number, the court or agency, and the current status?

Have you signed, or been asked to sign, any of the following?

A severance or separation agreementA release or waiver of claimsA settlement agreementA non-compete or non-solicitation agreementA confidentiality or non-disclosure agreementAn arbitration agreementNone of the above

If you have been asked to sign something, what is the deadline to sign, and have you signed it already?

_________________________________________________________

Key Documents & Evidence

What type of documents or evidence do you have?

select all that apply

Emails or LettersText Messages or Chat LogsContracts or signed agreementsPay Stubs or Wage StatementsPerformance Reviews or Disciplinary NoticesCourt or case filingsGovernment or agency letters and decisionsPhotos or VideosNames of WitnessesI have no documents

Please upload any documents you mentioned above.

Upload any of these you have: a contract or agreement, a termination or denial letter, anything you have been asked to sign, a right-to-sue or agency letter, court filings, and any letters or emails from the other side.

Document Upload #1:

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Document Upload #2:

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Document Upload #3:

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Goals & Desired Outcome

What do you want a lawyer to help you achieve?

Be specific. What would a lawyer accomplish here that you cannot accomplish on your own?

Someone owes me a specific sum of money and has not paid it

I lost my job, income, housing, or benefits and want to know if that was lawful

Something is happening right now that I need stopped

I have been sued, charged, or accused and need to defend myself

I have been asked to sign something and need to know what it means before I do

A government agency or institution denied me something and I want that decision reviewed

I want an official record, reference, or decision corrected

Administrative

Has an attorney ever represented you on this matter?

No

Yes — I am represented right now

Yes — I was represented, and that representation has ended

If yes, who represented you and why did it end?

How did you hear about Dresslar Law?

Select an option Google Search Friend/Family Referral Attorney Referral Yelp Social Media Other

Are you aware of any upcoming deadlines?

Yes

Please describe any deadlines, court dates, or response times you know about:

No

Final Confirmation

The information you have provided is true and accurate to the best of your knowledge.

I have read and understand the above statement.

Electronic Signature:

Type your name

Date:

_________________________________________________________

Thank You