Your Information

Preferred Name / Nickname:

Pronouns:

Select an option She/Her He/Him They/Them Prefer not to say Other

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:

Opposing Party's Address:

(if known)

Opposing Party's Phone Number:

(if known)

Your Relationship to Opposing Party:

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

Opposing Party's Attorney:

(if known)

Attorney's Law Firm:

(if known)

_________________________________________________________

Additional Opposing Party #1:

(if applicable)

Fill Out Information

Full Name of Opposing Person or Company: Opposing Party;s Address (if known): Opposing Party;s Phone Number (if known): Your Relationship to Opposing Party:

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

Opposing Party's Attorney (if known): Attorney's Law Firm (if known):

Not Applicable

Additional Opposing Party #2:

(if applicable)

Fill Out Information

Full Name of Opposing Person or Company: Opposing Party;s Address (if known): Opposing Party;s Phone Number (if known): Your Relationship to Opposing Party:

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

Opposing Party's Attorney (if known): Attorney's Law Firm (if known):

Not Applicable

Additional Opposing Party #3:

(if applicable)

Fill Out Information

Full Name of Opposing Person or Company: Opposing Party;s Address (if known): Opposing Party;s Phone Number (if known): Your Relationship to Opposing Party:

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

Opposing Party's Attorney (if known): Attorney's Law Firm (if known):

Not Applicable

_________________________________________________________

Your Case Details

What type of legal matter is this?

Select an option Employment: Discrimination or Harassment Employment: Retaliation or Whistleblower Employment: Wage & Hour Dispute Employment: Wrongful Termination Contract Dispute Other (please specify below)

If other, please specify:

Detailed Narrative:

Please describe the events in chronological order (from start to finish). Include key dates, locations, and the full names/roles of everyone involved. The more detail you can provide, the better.)

Date of the primary incident(s):

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

This is important for determining legal deadlines, known as the statute of limitations.

_________________________________________________________

Key Documents & Evidence

What type of documents or evidence do you have?

select all that apply

Emails or LettersText Messages or Chat LogsEmployment Contract or Offer LetterEmployee Handbook / HR PoliciesPay Stubs or Wage StatementsPerformance Reviews or Disciplinary NoticesLease Agreement or Rental DocumentsBusiness ContractsEEOC or HCRC "Right to Sue" LetterPhotos or VideosNames of Witnesses

Please upload any documents you mentioned above.

Examples: your employment contract, eviction notice, right-to-sue letter, or a key email chain. Multiple files/documents may be compressed and uploaded as a .Zip file.

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Document Upload #3:

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_________________________________________________________

Goals & Desired Outcome

What is your ideal outcome? Please describe what you hope to achieve by pursuing this legal matter.

For example: "I want to recover unpaid wages," "I want the harassment to stop,"I want to be reinstated to my job," "I want fair compensation for damages.")

_________________________________________________________

Administrative

How did you hear about Dresslar Law?

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

Have you spoken with other attorneys about this matter?

Yes

No

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