***NOTE: Our policy is to respond to your inquiry within 48 hours. If you believe that a quicker response is necessary (i.e., you have an urgent meeting scheduled with your manager or a hearing, etc., prior to that time) please explain your need and we will immediately let you know if we can help you sooner.
Date of Birth*
Does your employer employ at least 15 employees?*
Does your employer employ at least 20 employees?*
Does your employer employ at least 50 employees?*
Date of Hire*
What was rate of pay?*
0 of 100 max characters
Date of Adverse Employment Action*
Adverse Employment Action Taken*
TerminatedDemotedFailure to HireOther
Reason given by Employer for Adverse Action*
Reasons you feel were behind the Adverse Action*
Because of my age Yes No
Because of my gender Yes No
Because of my pregnancy Yes No
Because of my disability Yes No
Because of my religion Yes No
Because of my nationality Yes No
Because of my race Yes No
Because my doctor won't let me return to work at the end of my leave period Yes No
Because I filed for Workers' Compensation Yes No
Because I was falsely accused of wrongdoing Yes No
Because I filed a complaint Yes No
Because of a personal disagreement I had with my supervisor Yes No
Other, please describe below Yes No
Please explain/describe the circumstances for any of the above reasons that apply to your situation
Have you filed a complaint with any agency?*
If 'Yes', which Agency?
Have you received a ruling or decision or notice of your right to sue?*
If 'Yes', please state the ruling or decision, and the date of the decision or notice.
What losses have you suffered?*
0 of 700 max characters
(Lost wages- how much; lost bonuses/commissions;lost benefits; other)
Do you have an employment contract?*
If 'Yes', please provide a copy of your contract.
Are you represented by a union?*
Have you applied for unemployment benefits?*
Yes No Not Applicable
If 'Yes', were you awarded benefits?
If 'No', did you appeal?
If you appealed, what is the status of your appeal?
Have you been offered a Severange Agreement?*
Have you obtained other employment?*
If 'Yes', where?
If you have obtained other employment, what is your new Job Title?
If you have obtained other employment, what is your new rate of pay?
How did you learn about ELLIOT MORGAN PARSONAGE, PLLC?
THANK YOU FOR YOUR INQUIRY.