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- Form language (for SF)*
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- What pronouns do you use?*
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- What is your end goal in reaching out for legal help?*
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- What type of legal issues are you facing?*
- Do you feel you've been discriminated against?*
- I have been discriminated against because of my:*
- Have you ever been threatened by the person or company you worked for because you raised these concerns to them or for any other reason?*
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- Are you currently still working here?*
- Approximately what date did you start working?
- Approximately what date did you stop working?
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- Did you receive 30-minute meal breaks?*
- Did you receive 10-min breaks for every 4 hours of work?*
- Did you ever work more than 40 hours in a week or 12 hours in a day?*
- If you worked 40+ hours in a week or 12 hours in a day, were you paid overtime for this work?*
- Is there a non-compete agreement in your contract or anything else that prevents you from going to work for someone else?*
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- Were you referred to Towards Justice?*
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- Would you like to be contacted in the future about ways to support us in advocating for better laws to protect workers and others like you?*
- If needed, do we have your authorization to share your information with other Attorneys in our network? The shared information will remain confidential within our network of Attorneys.*
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- Should be Empty: